Individual provider Active NPI

Stacie Homan, NP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1689167132
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11346 Issued in AZ
Practice address
2055 W Hospital Dr Ste 255
Tucson, AZ 85704-7857
Phone
(520) 404-6833
NPI assigned
Jun 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 TAP11346 AZ
Family Nurse Practitioner 363LF0000X AP11346 AZ Primary

Addresses

Primary practice location

2055 W Hospital Dr Ste 255
Tucson, AZ 85704-7857

Mailing address

2055 W Hospital Dr Ste 255
Tucson, AZ 85704-7857
Phone (520) 547-5725

Other practice location 1

70 N Harrison Rd
Tucson, AZ 85748-3260
Phone (520) 324-4403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180725001821 AZ Practitioner - Nurse Practitioner 0547517336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

70 N Harrison Rd
Tucson, AZ 85748-3260
Phone (520) 324-4403

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP11346AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Feb 1, 2024 Accepting new patients
Iora Health, LLC Past Accepting new patients
Carondelet Medical Group, Inc Family PastSince Apr 18, 2023 Accepting new patients
Iora Health Massachusetts, P.C. Past Accepting new patients

Locations

2424 N Wyatt Dr
Ste 100
Tucson, AZ 85712
Phone (520) 324-2778

70 N Harrison Rd
Tucson, AZ 85748
Phone (520) 324-4403

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

10350 E Drexel Rd
Unit 110
Tucson, AZ 85747
Phone (520) 324-1727

Organizations & group practices 4

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": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1689167132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 W HOSPITAL DR STE 255",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047857",
            "telephone_number": "520-547-5725",
            "fax_number": "520-547-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 W HOSPITAL DR STE 255",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047857",
            "telephone_number": "520-404-6833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 N Harrison Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857483260",
            "country_code": "US",
            "telephone_number": "520-324-4403",
            "fax_number": "520-324-1409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "STACIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP11346",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.