Stacia D Petrancosta, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

500 W Annandale Rd
Falls Church, VA 22046

Phone

(703) 521-6662

NPI assigned

Mar 5, 2010

Last updated

Aug 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacia D Outten Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Wound Care Experts IncGroup PAC ID 8022537141, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Wound Care Experts Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Atlanta, GA
  • NPI 1770384919
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1063735959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 PINE CLUSTER CIR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221815440",
            "telephone_number": "910-578-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W ANNANDALE RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22046",
            "telephone_number": "703-521-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRANCOSTA",
        "first_name": "STACIA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIA",
            "last_name": "OUTTEN",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronica Petersen
• Catherine Sheehan Peterson, LCSW
• Michael Terrill Peterson, LCSW
• Rebecca Jane Peterson, PH.D.
• James Michael Petko, D.P.M.
• Kathleen R Petro, M.D.
• Avery Petrucci, PA-C
• Brian David Peyser, D.D.S
• Richard Allen Peyser, D.D.S
• Megan Pezzino

• Medical Physician Assistant in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.