Active NPI
Stacie Noel Liebelt, F.N P.
- Family Nurse Practitioner
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 14950
- Practice address
- 4335 N Star Way Ste a
Modesto, CA 95356-8628 - Phone
- (209) 342-5125
- Fax
- (209) 342-5128
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14950 | CA | Primary |
Addresses
Primary practice location
4335 N Star Way Ste a
Modesto, CA 95356-8628
Mailing address
4335 N Star Way Ste a
Modesto, CA 95356-8628
Phone (209) 342-5125
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 Sylvan Ave
Suite a
Modesto, CA 95350-1699
Phone (209) 248-7168
4335 -A N Star Way
Modesto, CA 95356-8628
Phone (209) 342-5125
Hospital & facility affiliations
- Adventist Health Sonora
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14950 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central California Bariatric Surgery, Partnership | Current | Accepting new patients | |
| Valley Wound Healing Center, Inc. | Current | Accepting new patients | |
| Central California Bariatric Surgery a Medical Corporation | Current | Accepting new patients |
Locations
1001 Sylvan Ave
Ste A
Modesto, CA 95350
Phone (209) 248-7168
4335 N Star Way
Ste A
Modesto, CA 95356
Phone (209) 342-5125
1552 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 248-7168
644 E Harding Way
Stockton, CA 95204
644 E Harding Way
Ste B
Stockton, CA 95204
Phone (209) 244-9191
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.
-
- Surgery Physician
- Modesto, CA
- NPI 1124141163
-
- Clinic/Center
- Modesto, CA
- NPI 1730285073
-
- Surgery Physician
- Modesto, CA
- NPI 1104632249
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sonora, CA
- NPI 1780673376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743984000000",
"number": "1295779387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4335 N STAR WAY STE A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953568628",
"telephone_number": "209-342-5125",
"fax_number": "209-342-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4335 N STAR WAY STE A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953568628",
"telephone_number": "209-342-5125",
"fax_number": "209-342-5128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBELT",
"first_name": "STACIE",
"middle_name": "NOEL",
"name_prefix": "Miss",
"credential": "F.N P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2025-04-07",
"certification_date": "2025-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "14950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.