STACY L FERNANDEZ-RODRIGUE (MD) – Emergency Medicine Physician, NPI 1083997456

STACY L FERNANDEZ-RODRIGUE (MD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. MT 200248 (PA). The NPI Number for STACY L FERNANDEZ-RODRIGUE (MD) is 1083997456

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
STACY L FERNANDEZ-RODRIGUE (MD)
NPI
1083997456
Phone
(504) 460-6278
Address
808 AUTUMN RIVER RUN
Enumeration Date
22 September 2011
Last Update Date
22 September 2011

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9857306700
Graduation Year
2011 (15 years ago)
PAC ID
8820217771
Group Practice PAC ID
4284928094
Professional Enrollment ID
I20140909000202
Address ID
LA704273729BO433XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

3,391 EMERGENCY MEDICINE in PA

Provider Addresses for STACY L FERNANDEZ-RODRIGUE (MD)

  • 808 AUTUMN RIVER RUN

    PHILADELPHIA, PA 191284360

    Phone: (504) 460-6278

    Type: Mailing

  • 1316 W ONTARIO ST

    PHILADELPHIA, PA 191405220

    Phone: (267) 294-8410

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-10-07 • Largest payer in this snapshot: ABBVIE INC. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$16
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: 2014-09-09

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
I20140909000202IEmergency MedicineLATBD

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
99285Emergency department visit with high level of medical decision making113113$0
99284Emergency department visit with moderate level of medical decision making4948$0
View full utilization report →

Insurance plans in this area (ZIP 19128)

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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: 4284928094View full group profile

Reviews

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Frequently asked questions

What identifier follows STACY L FERNANDEZ-RODRIGUE (MD) across health systems?
The NPI 1083997456 uniquely identifies STACY L FERNANDEZ-RODRIGUE (MD) in U.S. healthcare data.
Should I treat STACY L FERNANDEZ-RODRIGUE (MD) as an active provider?
Patients and plans typically see STACY L FERNANDEZ-RODRIGUE (MD) as active in the national extract.
What type of care does STACY L FERNANDEZ-RODRIGUE (MD) provide?
STACY L FERNANDEZ-RODRIGUE (MD)'s profile centers on Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to STACY L FERNANDEZ-RODRIGUE (MD)?
The directory associates STACY L FERNANDEZ-RODRIGUE (MD) with Philadelphia, Pennsylvania. Check all listed addresses for suites or satellite offices.
Can I export STACY L FERNANDEZ-RODRIGUE (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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