LISA RENEE STALEY (NP) – Family Nurse Practitioner, NPI 1649719816
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,989 NURSE PRACTITIONER in OH
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Provider Addresses for LISA RENEE STALEY (NP)
6435, West Jefferson Boulevard, Times Corner, Fort Wayne, Allen County, Indiana, 46804, United States
FORT WAYNE, IN 468046203
Phone: (260) 344-4035
Fax: (260) 969-9272
Type: Mailing
Mercer Health, 800, West Main Street, Coldwater, Mercer County, Ohio, 45828, United States
COLDWATER, OH 458281613
Phone: (260) 344-4035
Fax: (260) 969-9272
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $511.
Total Amount is formed as General ($511) + Research ($0) + Ownership ($0) = $511.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Abbott Laboratories ($234).
Total Amount
$511
General + Research + Ownership
Payments
18
Total payment records
General Amount
$511
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $234 |
| Novo Nordisk Inc | $116 |
| ABBVIE INC. | $87 |
| AstraZeneca Pharmaceuticals LP | $23 |
| Xeris Pharmaceuticals, Inc. | $19 |
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: 2017-10-11
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 |
|---|---|---|---|---|
| I20171011003898 | I | Nurse Practitioner | OH | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 19 | $0 |
Insurance plans in this area (ZIP 46804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OH | |
| Family Practice | OH | |
| Family Practice | OH | |
| Physician Assistant | OH | |
| - | OH | |
| General Surgery | OH | |
| Family Practice | OH | |
| - | OH | |
| Internal Medicine, Hospitalist | PA | |
| Registered Dietitian Or Nutrition Professional | OH |
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