Staci L Sampo, R.N.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

10106 Issued in CA

Practice address

1133 E Stanley Blvd
#103
Livermore, CA 94550-4200

Phone

(925) 455-5050

Fax

(925) 455-5084

NPI assigned

Jan 29, 2007

Last updated

Apr 2, 2013By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 8, 2024 through Feb 8, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Bruce M. Gach, M.D., Inc.

  dba Livermore/Pleasanton Pediatrics Group

  • Specialist
  • Livermore, CA
  • NPI 1801897806
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1750427613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E STANLEY BLVD",
            "address_2": "#103",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504200",
            "telephone_number": "925-455-5050",
            "fax_number": "925-455-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E STANLEY BLVD",
            "address_2": "#103",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504200",
            "telephone_number": "925-455-5050",
            "fax_number": "925-455-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPO",
        "first_name": "STACI",
        "middle_name": "L",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "10106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nora Nazieh Said
• Christopher Saincome, DC
• Maia Jane Sakradse, MD
• Brittany M Saldivar, CPT I
• Reta Samimi, PA-C
• Jessica W Sanchez
• Maruska Sanchez, NURSE PRACTITIONER
• Gurmanpal Singh Sandhu
• Sandia National Laboratories Ca
• Sandia National Labs

• Pediatric Nurse Practitioner in Livermore, CA
• Providers in Livermore, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.