STACY PETERSEN MEDICAL GROUP, P.C. – NPI #1194677955
Ophthalmology

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Health Care Provider Taxonomy Code for Ophthalmology

STACY PETERSEN MEDICAL GROUP, P.C. is an ophthalmologist located in RIVERSIDE, CA. NPPES has assigned the NPI number 1194677955 to STACY PETERSEN MEDICAL GROUP, P.C. on February 12, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207W00000X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STACY PETERSEN MEDICAL GROUP, P.C. below.

NPI Profile for
STACY PETERSEN MEDICAL GROUP, P.C.

NPI Number
1194677955
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STACY PETERSEN MEDICAL GROUP, P.C.
Primary location
4445 MAGNOLIA AVE
RIVERSIDE, CA 92501
Phone: (949) 991-4172 Fax: (949) 288-0429
Mailing address
26791 ALISO CREEK RD # 1018
ALISO VIEJO, CA 92656-2887
Phone: Fax: (949) 288-0429
Organization Subpart
No
Authorized Official
STACY DIFLEY
SECRETARY
Phone: (949) 991-4172
Updated
Certification Date
Feb 10, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207W00000X
- Ophthalmology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.