Stacy Petersen Medical Group, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

STACY PETERSEN MEDICAL GROUP, P.C.

Practice address

4445 Magnolia Ave
Riverside, CA 92501

Phone

(949) 991-4172

Fax

(949) 288-0429

NPI assigned

Feb 12, 2026

Organization subpart

No

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

Authorized official

Name

Stacy Difley, NP

Title

Secretary

Phone

(949) 991-4172

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacy Anne Petersen, FNP-C

  • Family Nurse Practitioner
  • Costa Mesa, CA
  • NPI 1144719527
  NPD

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

{
    "created_epoch": "1770854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1194677955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26791 ALISO CREEK RD # 1018",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562887",
            "fax_number": "949-288-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92501",
            "telephone_number": "949-991-4172",
            "fax_number": "949-288-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY PETERSEN MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-12",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "DIFLEY",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-991-4172",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Jude Medical Transportation
• Karen Jean St. Leger, CADC-CAS
• St. Peter Residence
• St. Rita Residence
• Isabella Stack
• Celeste Kimberly Stadelman
• Erica A Stafford, RBT
• Mona Stafford
• Sarah Stager
• Michelle Genesis Staggs

• Ophthalmology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.