Individual provider Active NPI

Tara Ann Stolnicki, RN

  • Family Nurse Practitioner
  • Portage, MI
National Provider Identifier
1679039762
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704276958 Issued in MI
Practice address
1911 W Centre Ave Ste 1
Portage, MI 49024-5367
Phone
(269) 342-9308
NPI assigned
Feb 14, 2019
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704276958 MI Primary
Hospice Registered Nurse 163WH1000X 4704276958 MI

Addresses

Primary practice location

1911 W Centre Ave Ste 1
Portage, MI 49024-5367

Mailing address

1911 W Centre Ave
Portage, MI 49024-5367
Phone (269) 598-1514

Other practice location 1

117 W Paterson St
Kalamazoo, MI 49007-2581
Phone (269) 349-2641

Other practice location 2

505 E Alcott St
Kalamazoo, MI 49001-6144
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20191004000260 MI Practitioner - Nurse Practitioner 7214166610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center, Inc.Group PAC ID 1759370216, 51 clinicians

Practice addresses (Care Compare)

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
93.09
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704276958MIMDHospice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc CurrentSince Aug 29, 2019 Accepting new patients
Family Health Center Inc CurrentSince Aug 29, 2019 Accepting new patients

Locations

117 W Paterson St
Kalamazoo, MI 49007

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

Organizations & group practices 2

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.

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1679039762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245367",
            "telephone_number": "269-598-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 W CENTRE AVE STE 1",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245367",
            "telephone_number": "269-342-9308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W Paterson St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072581",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E Alcott St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490016144",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLNICKI",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704276958",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "MI",
            "license": "4704276958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.