Amy Stacey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085007306 Issued in IL

Practice address

502 W Saint Louis St Ste 4
West Frankfort, IL 62896-1968

Phone

(618) 937-3400

Fax

(618) 997-9324

NPI assigned

Dec 24, 2019

Last updated

Dec 24, 2019By 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 identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Illinois Specialty Clinic, Inc.Group PAC ID 9830562016, 145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184

Merit-based Incentive Payment System (MIPS)

Final score

77.51 of 100Reported as group

Quality

49.04

Promoting interoperability

95

Improvement activities

40

Cost

69.42

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.stacey.1@27782.direct.athenahealth.com
• Direct secure messaging: astace02@yourcarecommunity.org
• Direct secure messaging: astacey416664@direct.deaconess.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.

• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess IL Specialty 3331 DeYoung

  • Surgery Physician
  • Marion, IL
  • NPI 1972210235
  Medicare reassignment Care Compare group
• Southern Illinois Medical Services, NFP

  dba SIH Medical Group

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess IL Specialty 4117 Water Tower

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1003523374
  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess Care Group Illinois Union County

  • Hospitalist Physician
  • Anna, IL
  • NPI 1225858251

  Physician Assistant

  NPD
• Deaconess Illinois Clinic, Inc

  dba Deaconess Illinois Clinic

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1245956523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Regional Healthcare Services Illinois Inc

  dba Deaconess Illinois Medical Center

  • General Acute Care Hospital
  • Marion, IL
  • NPI 1750007266
  Care Compare affiliation

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

{
    "created_epoch": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1962041830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W SAINT LOUIS ST STE 4",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961968",
            "telephone_number": "618-937-3400",
            "fax_number": "618-997-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W SAINT LOUIS ST STE 4",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961968",
            "telephone_number": "618-937-3400",
            "fax_number": "618-997-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "AMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-24",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI SPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Surgical Appliance Co
• Sue C Speers
• Marie A Spelich
• Spero Family Services
• Stacey A Springer
• Stacy Gardner (Professional Health Services)
• Tonya Steele, LPN
• Stephen L Ponton DPM
• Jennifer L Stowers
• Lisa R Stritzel

• Physician Assistant in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.