Stacey Pittner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA-055904 Issued in PA

Practice address

765 Liberty Street
Suite 111
Meadville, PA 16335

Phone

(814) 336-6384

Fax

(814) 724-2771

NPI assigned

Mar 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stacey Ferguson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: staceyferguson@meadvillepediatrics.medentdirect.com

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.

• Meadville Pediatrics, PC

  • Pediatrics Physician
  • Meadville, PA
  • NPI 1184654857
  NPD (past)

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1821339151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 LIBERTY STREET",
            "address_2": "SUITE 111",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-336-6384",
            "fax_number": "814-724-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LIBERTY STREET",
            "address_2": "SUITE 111",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-336-6384",
            "fax_number": "814-724-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTNER",
        "first_name": "STACEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055904",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA-055904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "FERGUSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber Phillips, LCSW
• Jeffrey Thomas Pianta, RPH
• Pinnacle Treatment Centers PA-VI, LLC
• Pioneer Medical Associates
• Pamela Piotrowski
• Peter R. Pless, M.D.
• Erica Lynn Ploski, LPC
• Susan Galfo Plunkett, N.P.
• Constantine Poolos
• Jennifer Porter, LPC

• Physician Assistant in Meadville, PA
• Providers in Meadville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.