Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacey Marie Mermigos

Individual provider Registered Nurse · NPI 1700598927

Stacey Marie Mermigos is a Nurse Practitioner in Portland, Oregon. Qualified in 2022, 4 years ago. Practices with University Professional Services, a 1,704-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Licensed in
PA
In the registry since
2022
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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-5300
Fax: (503) 494-6519
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence RN719449 (PA)

Record details

NPI number1700598927
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 19, 2022
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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