STACEY PAULT (PA-C) – Medical Physician Assistant, NPI 1356621643
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,161 PHYSICIAN ASSISTANT in CO
Provider Addresses for STACEY PAULT (PA-C)
1339 S PUEBLO BLVD
PUEBLO, CO 810051686
Phone: (719) 564-9400
Type: Mailing
230 E MARYDALE AVE
SOLDOTNA, AK 996697648
Phone: (907) 262-3119
Fax: (907) 262-9290
Type: Mailing
1339 S Pueblo Blvd
Pueblo, CO 810051686
Phone: (719) 564-9400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-02-22
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 |
|---|---|---|---|---|
| I20180222002526 | I | Physician Assistant | AK | 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 |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 27 | 20 | $0 |
| 93005 | Routine electrocardiogram (ecg) using at least 12 leads with tracing | 18 | 18 | $0 |
Insurance plans in this area (ZIP 81005)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AK | |
| Mental Health Counselor | AK | |
| Nurse Practitioner | AK | |
| Family Practice | AK | |
| - | AK | |
| O P T O M E T R Y | CA | |
| Nurse Practitioner | AK | |
| Nurse Practitioner | FL | |
| Clinical Psychologist | AK | |
| P S Y C H I A T R Y | WA |
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