STACEY WADDINGTON (PA-C) – Physician Assistant, NPI 1154578615
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for STACEY WADDINGTON (PA-C)
200 S CEDAR ST
SHELBYVILLE, IL 625651838
Phone: (217) 774-4400
Fax: (217) 774-6445
Type: Location
800, North 1st Street, Springfield, Sangamon County, Illinois, 62702, United States
SPRINGFIELD, IL 627023719
Phone: (217) 528-7541
Type: Location
1025, South 6th Street, South Town, Springfield, Sangamon County, Illinois, 62703, United States
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 76 Open Payments records for all available years, with a total value of $1,270.
Total Amount is formed as General ($1,270) + Research ($0) + Ownership ($0) = $1,270.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: ABBVIE INC. ($189).
Total Amount
$1,270
General + Research + Ownership
Payments
76
Total payment records
General Amount
$1,270
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $189 |
| Amgen Inc. | $178 |
| Novartis Pharmaceuticals Corporation | $149 |
| Novo Nordisk Inc | $147 |
| AstraZeneca Pharmaceuticals LP | $115 |
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: 2008-09-24
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 |
|---|---|---|---|---|
| I20080924000199 | I | Physician Assistant | IL | 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 62565)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 51798 | Ultrasound measurement of bladder capacity after voiding | 84 | 82 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO |
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