Staci L Drosopoulos, PA-C, ATC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085.005573 Issued in IL

Practice address

101 E Miller Rd
Sterling, IL 61081

Phone

(815) 625-4790

NPI assigned

Aug 18, 2009

Last updated

Dec 12, 2018By 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

Other names 1

• Staci L Vonholten Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdrosopoulos21130@cghmc.direct-ci.com

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.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Medicare reassignment NPD
• CGH Medical Center

  dba CGH Medical Center-Morrison

  • Durable Medical Equipment & Medical Supplies
  • Morrison, IL
  • NPI 1447415724
  NPD

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1750513164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "61081",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROSOPOULOS",
        "first_name": "STACI",
        "middle_name": "L",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.005573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "VONHOLTEN",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana Lyn Dietz, CMT
• Staci L Dirks, SLP
• Morgan Donaldson, LPC
• Terry L Donat, MD
• Dr Amit Kalra LLC (Dental Care of Sterling)
• Michael Duerst
• Courtney M Duffy, APRN, CNM
• Jesse Duran
• Paula K Durband, LCPC
• Jeffrey Dyke, P.T.

• Medical Physician Assistant in Sterling, IL
• Providers in Sterling, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.