Individual provider Active NPI

Stacey Amber Gerbrandt, PA-C

  • Otolaryngology Physician
  • Valencia, CA
National Provider Identifier
1083845887
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
20424 Issued in CA
Practice address
27879 Smyth Dr
Valencia, CA 91355-4011
Phone
(661) 259-2500
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20424 CA
Otolaryngology Physician 207Y00000X 20424 CA Primary

Addresses

Primary practice location

27879 Smyth Dr
Valencia, CA 91355-4011

Mailing address

27879 Smyth Dr
Valencia, CA 91355-4011
Phone (661) 259-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20101102000808 CA Practitioner - Physician Assistant 9133313265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Clarita Ear Nose and Throat Medical AssociatesGroup PAC ID 5597774570, 8 clinicians

Practice addresses (Care Compare)

27879 Smyth Dr
Valencia, CA 91355-4011
Phone (661) 259-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20424CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Otolaryngology Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1083845887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27879 SMYTH DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554011",
            "telephone_number": "661-259-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27879 SMYTH DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554011",
            "telephone_number": "661-259-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBRANDT",
        "first_name": "STACEY",
        "middle_name": "AMBER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20424",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "20424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.