Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Staci L Wall , NP

Nurse Practitioner โ€ข Fort Wayne, IN

Active NPI 1629068291 Individual Practitioner Female Practitioner
Practice location in NPPES

7988 W Jefferson Blvd
Fort Wayne, IN 468044140

Call 2604324400 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

7988 W Jefferson Blvd

Fort Wayne, IN 468044140

Telephone 2604324400
Fax 2609696898
Organization at the Same NPPES Address or Phone
Associated Surgeons And Physicians, Llc Facility NPI 1083868269

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Medicare-allowed amount

About $6,748 in 2018

The total amount Medicare approved for these services in 2018. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2018.

Paid by Medicare

About $5,300 in 2018

The part of the Medicare-allowed amount that Medicare itself paid in 2018, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2018.

30-day fills

64 standardized 30-day fills in 2019

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$1,423 in 2019

The total cost of these prescriptions in 2019, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2019.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021โ€“2025.

Guide: How to read an Open Payments record

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

Billing and prescribing volume is not a quality rating.

Medicare Part B

Comparisons use 2024 data. The latest CMS data for Staci Wall are from 2018.

Medicare Part D

Comparisons use 2024 data. The latest CMS data for Staci Wall are from 2019.

524 active clinicians are listed under Nurse Practitioner with a practice address in Fort Wayne, IN (2,582 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Wayne

23.1% of these 524 clinicians have the CMS telehealth indicator.

72.7% of these 524 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2018), CMS Medicare Part D Prescribers (2019), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2018.

CMS Part B ยท Data Year 2018
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ€“2017 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2017โ€“2018; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination
52 52 $54.81 $28.32
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
35 29 $105.00 $58.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
30 24 $154.00 $84.50
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
20 20 $60.00 $34.98

Source: CMS Part B by Provider and Service, 2018; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2019.

CMS Part D ยท Data Year 2019
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Estradiol Estradiol 40 1,886 $1,422.96 12

Source: CMS Part D by Provider and Drug, 2019; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

License # reported to NPPES IN 71003769

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Registered Nurse

NUCC Taxonomy Code: 163W00000X

License # reported to NPPES IN 28086186

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
200338300 (IN)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

24 listed
Dr. Tracy Bellavance , MD

Obstetrics & Gynecology

NPI 1588659064

Doctor of Medicine (M.D.)

Caroline Calvert , NP

Nurse Practitioner - Family

NPI 1609277490

Nurse Practitioner

Dr. Adrianna Darwish , DO

Obstetrics & Gynecology

NPI 1912498528

Doctor of Osteopathic Medicine (D.O.)

Dr. Keith Davis , MD

Obstetrics & Gynecology

NPI 1235129859

Doctor of Medicine (M.D.)

Michelle Durrant

Obstetrics & Gynecology

NPI 1285097634
Dr. Lucia Fouts Grubbs , MD

Obstetrics & Gynecology

NPI 1679563399

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
โœ…
NPI Profile Active January 31, 2018

NPI status registered as active in NPPES database

๐Ÿ“
Updated Practice Location January 31, 2018

Registered at 7988 W JEFFERSON BLVD, FORT WAYNE, IN 468044140 (Tel: 2604324400)

๐Ÿ“
Updated Business Mailing Address January 31, 2018

Registered at 2518 E DUPONT RD, FORT WAYNE, IN 468251675 (Tel: 2604324400)

๐Ÿ‘ค
Provider Name / Credentials Updated January 31, 2018

Recorded as STACI WALL, NP

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2018

Registered Nurse (license number reported to NPPES: IN 28086186)

โœ…
NPI Profile Active December 21, 2016

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) December 21, 2016

Registered at 7988 W JEFFERSON BLVD, FORT WAYNE, IN 468044140 (Tel: 2604324400)

๐Ÿ“
Business Mailing Address (Initial Record) December 21, 2016

Registered at 2518 E DUPONT RD, FORT WAYNE, IN 468251675 (Tel: 2604324400)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) December 21, 2016

Recorded as STACI WALL, NP

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2016

Registered Nurse (license number reported to NPPES: IN 28086186)

๐ŸŸข
Initial NPI Registration & Enumeration October 25, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1629068291
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 25, 2005
Last Update: January 31, 2018
Sole Proprietor: No

Other Nurse Practitioners in Fort Wayne

All Nurse Practitioners in Fort Wayne

Mailing Address

2518 E Dupont Rd

Fort Wayne, IN 468251675

Phone: 2604324400

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.