Individual provider Active NPI

Stacie Christine Bennett, MD

  • Neonatal-Perinatal Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1982660080
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
A74688 Issued in CA
Practice address
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone
(925) 947-5350
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A74688 CA
Neonatal-Perinatal Medicine Physician 2080N0001X A74688 CA Primary
Specialist 174400000X A74688 CA

Addresses

Primary practice location

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122

Mailing address

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone (925) 947-5350

Other practice location 1

747 52nd St
Neonatology 3rd Floor
Oakland, CA 94609-1809
Phone (510) 428-3276

Other practice location 2

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250917003375 CA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4183128721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, Davis School of Medicine, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Pasteur Dr
RM P388
Palo Alto, CA 94304-1048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A74688CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Sep 3, 2025 Accepting new patients
East Bay Newborn Specialists, Inc. Neonatal-Perinatal Medicine Past Accepting new patients

Locations

747 52nd St
Fl 3
Oakland, CA 94609
Phone (510) 428-3276

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1982660080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-947-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-947-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_2": "Neonatology 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091809",
            "country_code": "US",
            "telephone_number": "510-428-3276",
            "fax_number": "510-450-5823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "650-497-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STACIE",
        "middle_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A74688",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A74688",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A74688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.