CMS-1500 Box 24J / 33a • NPI
1851556658
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
6 JOHNSON ST, OWEN, WI, 54460-9534
✓ 9-Digit EDI 837 ZIP+4 (54460-9534)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1851556658 (STACEY L GUSMAN, APNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1851556658)
Medicare Beneficiaries
154
Total Billed Services
513
Distinct CPT/HCPCS Codes
22
Medicare Allowed Total
$32,735.24
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 114 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 129 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 106 |
G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 30 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 53 | 24 |
| Alendronate Sodium Alendronate Sodium | 25 | <11 |
| Allopurinol Allopurinol | 74 | 22 |
| Alprazolam Alprazolam | 43 | <11 |
| Amitriptyline Hcl Amitriptyline Hcl | 19 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 271 | 79 |
| Amoxicillin Amoxicillin | 35 | 20 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 16 | 14 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1851556658 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | STACEY L GUSMAN, APNP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 6 JOHNSON ST, OWEN, WI, 54460-9534 |
| Practice Telephone / Fax | Tel: (715) 229-2177 | Fax: (715) 229-4450 |
| Administrative Mailing Address | 6 JOHNSON ST, OWEN, WI, 54460-9534 |
| Enumeration & Last Sync | Enumerated: 2008-07-22 | CMS Record Updated: 2009-10-01 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (STACEY L GUSMAN, APNP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: WI | License: 3467 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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