Staci Walters (NPI# 1417173832, PAC ID# 9739128273) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1417173832 |
| PAC ID by PECOS | 9739128273 |
| Professional Enrollment ID | I20110920000579 |
| Full Name | Staci Walters |
| Organization Legal Name | SPACE COAST OPHTHALMOLOGY LLC |
| Address |
1832 Garden St Titusville FL 32796-3200 |
| Phone Number | 3213833937 |
| Gender | F |
| Credential | OD |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2003 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 4688950611 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 665 S Apollo Blvd, Melbourne, FL 32901-1485 | 3219843200 | BREVARD EYE CENTER INC |
| 7775 N Wickham Rd, Melbourne, FL 32940-7914 | 3219843200 | BREVARD EYE CENTER INC |
| 1832 Garden St, Titusville, FL 32796-3200 | 3213833937 | SPACE COAST OPHTHALMOLOGY LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 99% |
| Organization Legal Name | SPACE COAST OPHTHALMOLOGY LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas A Pefkaros | Ophthalmology | Space Coast Ophthalmology LLC | 1832 Garden St, Titusville, FL 32796-3200 |
| Susan B Woods | Optometry | Space Coast Ophthalmology LLC | 1832 Garden St, Titusville, FL 32796-3200 |
| Street Address |
1832 GARDEN ST |
| City | TITUSVILLE |
| State | FL |
| Zip | 32796-3200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas A Pefkaros | Ophthalmology | Space Coast Ophthalmology LLC | 1832 Garden St, Titusville, FL 32796-3200 |
| Susan B Woods | Optometry | Space Coast Ophthalmology LLC | 1832 Garden St, Titusville, FL 32796-3200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Slone | Nurse Practitioner | Moore Medical Group Inc | 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310 |
| Eric A Moore | Family Medicine | Moore Medical Group Inc | 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310 |
| Mayra A Abelleira Martinez | Psychiatry | 2355 Truman Scarborough Way, Attn Cfo, Titusville, FL 32796-1310 | |
| Ismael A Beloso | Family Medicine | Moore Medical Group Inc | 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310 |
| Charles Ikegwuonu | Nurse Practitioner | Moore Medical Group Inc | 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310 |
| Laura Kn Powell | Nurse Practitioner | Moore Medical Group Inc | 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310 |
| Debra Kay Allen | Nurse Practitioner | Indian River Medical Office Pa | 3300 Dairy Rd, Titusville, FL 32796-1512 |
| Aluino L Ochoa | Internal Medicine | Indian River Medical Office Pa | 3300 Dairy Rd, Titusville, FL 32796-1512 |
| Cheryl M Gardner | Nurse Practitioner | Indian River Medical Office Pa | 3300 Dairy Rd, Titusville, FL 32796-1512 |
| Kimberly E Lundquist | Nurse Practitioner | Indian River Medical Office Pa | 3300 Dairy Rd, Titusville, FL 32796-1512 |
| Find all physicians in zip 32796 | |||
| City | TITUSVILLE |
| Zip Code | 32796 |
| Specialty | OPTOMETRY |
| City + Specialty | TITUSVILLE + OPTOMETRY |
Please comment or provide details below to improve the information on Staci Walters.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.