STACEY R SPROULL (ARNP) – Gerontology Nurse Practitioner, NPI 1528412624
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for STACEY R SPROULL (ARNP)
364 SE 8TH AVE STE 108A
HILLSBORO, OR 971234253
Phone: (503) 494-8417
Fax: (503) 494-4455
Type: Mailing
Veronica S Shoemaker Blvd, Fort Myers, Lee County, Florida, 33916, United States
ATTN: CREDENTIALING
FORT MYERS, FL 339162216
Phone: (239) 432-8200
Fax: (813) 976-7895
Type: Mailing
61 Memorial Medical Pkwy Ste 212
Palm Coast, FL 321645981
Phone: (386) 586-1860
Type: Location
61, Memorial Medical Parkway, Palm Coast, Flagler County, Florida, 32164, United States
SUITE 2812
PALM COAST, FL 321645981
Phone: (386) 586-1860
Fax: (386) 586-1861
Type: Location
61 MEMORIAL MEDICAL PKWY STE 2812
PALM COAST, FL 321645999
Phone: (386) 586-1860
Fax: (386) 586-1861
Type: Mailing
61 MEMORIAL MEDICAL PKWY STE 212
PALM COAST, FL 321645981
Phone: (386) 586-1860
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 39 Open Payments records for all available years, with a total value of $1,314.
Total Amount is formed as General ($1,314) + Research ($0) + Ownership ($0) = $1,314.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Janssen Biotech, Inc. ($330).
Total Amount
$1,314
General + Research + Ownership
Payments
39
Total payment records
General Amount
$1,314
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $330 |
| Genmab U.S., Inc. | $156 |
| G1 Therapeutics, Inc. | $146 |
| Novartis Pharmaceuticals Corporation | $128 |
| Lilly USA, LLC | $50 |
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: 2024-02-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20160603001039 | I | Nurse Practitioner | FL | TBD |
| I20220411001469 | I | Nurse Practitioner | WA | TBD |
| I20240216002402 | I | Nurse Practitioner | OR | 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 | 191 | 98 | $0 |
Insurance plans in this area (ZIP 97123)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| - | IL | |
| O P H T H A L M O L O G Y | OR | |
| O P H T H A L M O L O G Y | WA | |
| Nurse Practitioner | WA | |
| Family Practice | WA | |
| Interventional Radiology, Diagnostic Radiology | OH | |
| Physician Assistant | ID | |
| Clinical Psychologist | WA |
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