MRS. STACIE ANN BENKULA (FNP) – Family Nurse Practitioner, NPI 1174116180
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,802 NURSE PRACTITIONER in ID
Provider Addresses for MRS. STACIE ANN BENKULA (FNP)
PO BOX 5644
TWIN FALLS, ID 833035644
Phone: (208) 731-2090
Type: Mailing
2167 VILLAGE PARK AVE STE 300
TWIN FALLS, ID 833014175
Phone: (208) 733-5117
Fax: (208) 733-5143
Type: Location
857 POLK ST
TWIN FALLS, ID 833014095
Phone: (208) 731-9404
Fax: (208) 213-9822
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 44 Open Payments records for all available years, with a total value of $991.
Total Amount is formed as General ($991) + Research ($0) + Ownership ($0) = $991.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($700).
Total Amount
$991
General + Research + Ownership
Payments
44
Total payment records
General Amount
$991
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $700 |
| Grifols USA, LLC | $129 |
| AstraZeneca Pharmaceuticals LP | $54 |
| SANOFI PASTEUR INC. | $23 |
| Novo Nordisk Inc | $20 |
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: 2023-10-09
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 |
|---|---|---|---|---|
| I20231009003068 | I | Nurse Practitioner | ID | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID |
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