Stacy Nicole Ross, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 19958 Issued in CA

Practice address

1510 E Herndon Ave Ste 230
Fresno, CA 93720-3392

Phone

(559) 450-2663

Fax

(559) 450-2724

NPI assigned

Sep 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.57 of 100Reported as group

Quality

63.43

Promoting interoperability

98

Improvement activities

40

Cost

77.49

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacy.ross.p1@direct.spocortho.nextgenshare.com

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.

• Community Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1811258510
  Medicare reassignment Care Compare group
• J&P Spine Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1164980744
  Medicare reassignment NPD
• Sierra Pacific Orthopaedic Center Medical Group, Inc.

  • Specialist
  • Fresno, CA
  • NPI 1285669655
  Medicare reassignment NPD
• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482
  Medicare reassignment
• LQMG Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1437166360
  NPD

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1174773808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E HERNDON AVE STE 230",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203392",
            "telephone_number": "559-450-2663",
            "fax_number": "559-450-2724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 E Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203305",
            "country_code": "US",
            "telephone_number": "559-256-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 19958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina June Ross
• Robert Ray Ross
• Sarah Ross
• Sharon Ross
• Sharon Marie Ross
• Irma Rossel, LVN
• Marilyn Candelaria Rossel, LPT
• Brandon Rosser
• Warren Rost
• Rhonda Roth

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.