MS. STACY NICOLE ROSS (PA-C) – Physician Assistant, NPI 1174773808
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for MS. STACY NICOLE ROSS (PA-C)
1510 E HERNDON AVE STE 230
FRESNO, CA 937203392
Phone: (559) 450-2663
Fax: (559) 450-2724
Type: Location
1630 E Herndon Ave
Fresno, CA 937203305
Phone: (559) 256-5200
Type: Location
1630, East Herndon Avenue, Fresno, Fresno County, California, 93720, United States
FRESNO, CA 937203305
Phone: (559) 256-5200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $892.
Total Amount is formed as General ($892) + Research ($0) + Ownership ($0) = $892.
Last reported payment date: 2024-08-02 • Largest payer in this snapshot: Abbott Laboratories ($265).
Total Amount
$892
General + Research + Ownership
Payments
16
Total payment records
General Amount
$892
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $265 |
| Medtronic, Inc. | $200 |
| SPR Therapeutics, Inc | $164 |
| ABBVIE INC. | $125 |
| Nevro Corp. | $122 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-04-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090429000451 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 200 | 138 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 70 | 65 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 93720)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management | CA | |
| Pain Management | CA | |
| Physical Therapist In Private Practice | CA | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | OH | |
| Clinical Social Worker | CA |
Reviews
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