DR. STACI DAWN ECENBARGER (O.D.) – Optometrist, NPI 1861449225

DR. STACI DAWN ECENBARGER (O.D.) is a healthcare provider. based in Wyoming, Michigan. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 4901004004 (MI). The NPI Number for DR. STACI DAWN ECENBARGER (O.D.) is 1861449225

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. STACI DAWN ECENBARGER (O.D.)
NPI
1861449225
Phone
(616) 532-2020
Address
5751 BYRON CENTER AVE SW
Enumeration Date
30 May 2006
Last Update Date
30 October 2007

Doctor Profile

Medical School Name
FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Secondary Phone
6165322020
Graduation Year
1999 (27 years ago)
PAC ID
1759391626
Group Practice PAC ID
4284634122
Professional Enrollment ID
I20060424000172
Address ID
MI495199622WY5751XVXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,203 OPTOMETRY in MI

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Provider Addresses for DR. STACI DAWN ECENBARGER (O.D.)

  • 5751, Byron Center Avenue Southwest, Wyoming, Kent County, Michigan, 49519, United States

    SUITE V

    WYOMING, MI 495199621

    Phone: (616) 532-2020

    Fax: (616) 532-2022

    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 15 Open Payments records for all available years, with a total value of $359.

Total Amount is formed as General ($359) + Research ($0) + Ownership ($0) = $359.

Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Alcon Vision LLC ($190).

Total Amount

$359

General + Research + Ownership

Payments

15

Total payment records

General Amount

$359

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-09

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: 2006-04-24

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060424000172IOptometryMITBD

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
92014Established patient complete exam of visual system3837$0
99214Established patient office or other outpatient visit, 30-39 minutes1514$0
View full utilization report →

Insurance plans in this area (ZIP 49519)

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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: 4284634122View full group profile
NameSpecialtyState
O P T O M E T R YMI

Reviews

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Frequently asked questions

How is DR. STACI DAWN ECENBARGER (O.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. STACI DAWN ECENBARGER (O.D.) with NPI 1861449225.
Can I rely on DR. STACI DAWN ECENBARGER (O.D.) being an active provider?
As of the registry snapshot, DR. STACI DAWN ECENBARGER (O.D.) is marked active.
What taxonomy line describes DR. STACI DAWN ECENBARGER (O.D.)?
For research purposes, treat DR. STACI DAWN ECENBARGER (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. STACI DAWN ECENBARGER (O.D.) list a practice location?
Patients near Wyoming, Michigan may find DR. STACI DAWN ECENBARGER (O.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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