STACEY ELAINE ODDERA (APRN) – Nurse Practitioner, NPI 1558964080
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for STACEY ELAINE ODDERA (APRN)
PO BOX 3988
CARBONDALE, IL 629023988
Phone: (618) 457-5200
Type: Mailing
2808 OUTER DR
MARION, IL 629595207
Phone: (618) 993-3817
Fax: (618) 993-3908
Type: Location
405 Rushing Dr
Herrin, IL 629483730
Phone: (618) 993-3300
Fax: (618) 993-0262
Type: Location
502 W Saint Louis St Ste 4
West Frankfort, IL 628961968
Phone: (618) 937-3400
Fax: (618) 997-9324
Type: Location
2601 W Main St
Carbondale, IL 629011031
Phone: (618) 549-5361
Fax: (618) 351-4878
Type: Location
117 E Clark St
Harrisburg, IL 629462702
Phone: (618) 252-8625
Fax: (618) 351-4859
Type: Location
98 PEACH RIDGE RD
ANNA, IL 629062243
Phone: (618) 614-1400
Fax: (618) 614-1401
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $355.
Total Amount is formed as General ($355) + Research ($0) + Ownership ($0) = $355.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: ABBVIE INC. ($233).
Total Amount
$355
General + Research + Ownership
Payments
13
Total payment records
General Amount
$355
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $233 |
| Novo Nordisk Inc | $68 |
| Otsuka America Pharmaceutical, Inc. | $24 |
| Exact Sciences Corporation | $16 |
| Dexcom, Inc. | $14 |
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: 2022-01-27
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 |
|---|---|---|---|---|
| I20220127001898 | I | Nurse Practitioner | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 45 | 40 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 24 | 24 | $0 |
| 81002 | Urinalysis, manual test | 11 | 11 | $0 |
Insurance plans in this area (ZIP 62902)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Nurse Practitioner | MI | |
| - | IL | |
| Infectious Disease | IL | |
| Emergency Medicine, Family Practice | TN | |
| Physician Assistant | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Nurse Practitioner | FL | |
| Physician Assistant | IL |
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