MRS. STACEY TEBBE – Nurse Practitioner, NPI 1073158119

MRS. STACEY TEBBE is a healthcare provider. based in Mattoon, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209020253 (IL). The NPI Number for MRS. STACEY TEBBE is 1073158119

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
MRS. STACEY TEBBE
NPI
1073158119
Phone
(217) 234-5110
Address
101 COLES CENTRE DR
Enumeration Date
13 November 2019
Last Update Date
29 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2173422121
Graduation Year
2019 (7 years ago)
PAC ID
9537590898
Group Practice PAC ID
2365341211
Professional Enrollment ID
I20200521000013
Address ID
IL624012006EF503XXSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MRS. STACEY TEBBE

  • 101 COLES CENTRE DR

    MATTOON, IL 619389314

    Phone: (217) 234-5110

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 241 Open Payments records for all available years, with a total value of $4,499.

Total Amount is formed as General ($4,499) + Research ($0) + Ownership ($0) = $4,499.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($668).

Total Amount

$4,499

General + Research + Ownership

Payments

241

Total payment records

General Amount

$4,499

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-05-21

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200521000013INurse PractitionerILTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes19480$0
99213Established patient office or other outpatient visit, 20-29 minutes5839$0
97597Removal of tissue from wound, 20.0 sq cm or less2913$0
99215Established patient office or other outpatient visit, 40-54 minutes2119$0
G0008Administration of influenza virus vaccine1717$0
View full utilization report →

Insurance plans in this area (ZIP 61938)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365341211View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)IL
Nurse PractitionerIL
-IL
Family PracticeIL
-IL
General SurgeryIL
N E U R O L O G YIN
General Surgery, Critical Care (Intensivists)IL
Internal Medicine, Pediatric MedicineIL
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineIL

Reviews

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Frequently asked questions

Is there an official ID for MRS. STACEY TEBBE in U.S. healthcare records?
The official identifier for MRS. STACEY TEBBE is NPI 1073158119.
Is there an active status for MRS. STACEY TEBBE?
For scheduling context, MRS. STACEY TEBBE is shown as active in the registry.
What kind of doctor is MRS. STACEY TEBBE?
MRS. STACEY TEBBE is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. STACEY TEBBE?
Directory geography for MRS. STACEY TEBBE centers on Mattoon, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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