STACEY J GIBSON (PA-C) – Physician Assistant, NPI 1376820340

STACEY J GIBSON (PA-C) is a healthcare provider. based in Spring grove, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. MA055299 (PA). The NPI Number for STACEY J GIBSON (PA-C) is 1376820340

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
STACEY J GIBSON (PA-C)
NPI
1376820340
Phone
(717) 225-9869
Address
2030 THISTLE HILL DR STE 100
Enumeration Date
4 November 2011
Last Update Date
2 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7177822143
Graduation Year
2011 (15 years ago)
PAC ID
3577738053
Group Practice PAC ID
7618960493
Professional Enrollment ID
I20111212000551
Address ID
PA171101904HA2501XFLOO601
Telehealth
Yes

Contacts

Secure Messaging
sgibson86031@phsdirect.pinnaclehealth.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:14State licenses:1Other namesUpdated within 12 months

9,691 PHYSICIAN ASSISTANT in PA

Provider Addresses for STACEY J GIBSON (PA-C)

  • 2030 THISTLE HILL DR STE 100

    SPRING GROVE, PA 173621160

    Phone: (717) 225-9869

    Fax: (717) 225-6552

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2011-12-12

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
I20111212000551IPhysician AssistantPATBD

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
99214Established patient office or other outpatient visit, 30-39 minutes11048$0
99213Established patient office or other outpatient visit, 20-29 minutes2020$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit2020$0
G0444Annual depression screening, 5 to 15 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 17362)

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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: 7618960493View full group profile
NameSpecialtyState
Nurse PractitionerPA
Family PracticePA
-PA
Nurse PractitionerPA
-PA
O B S T E T R I C S/ G Y N E C O L O G YIL
O B S T E T R I C S/ G Y N E C O L O G YPA
-TN
Hospitalist, Internal MedicinePA
Internal MedicinePA

Reviews

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Frequently asked questions

What is the registry number for STACEY J GIBSON (PA-C)?
The registry entry for STACEY J GIBSON (PA-C) shows NPI 1376820340.
Should I treat STACEY J GIBSON (PA-C) as an active provider?
Patients and plans typically see STACEY J GIBSON (PA-C) as active in the national extract.
What services align with STACEY J GIBSON (PA-C)'s listing?
STACEY J GIBSON (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to STACEY J GIBSON (PA-C)?
The directory associates STACEY J GIBSON (PA-C) with Spring Grove, Pennsylvania. Check all listed addresses for suites or satellite offices.
Can I export STACEY J GIBSON (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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