Stacey Ann Gennis, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN216459 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-6000

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgennis26070@direct.bostonchildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boston Childrens Heart Foundation Inc

  • Pediatric Cardiology Physician
  • Boston, MA
  • NPI 1982680922

  MA, Pediatrics

  Medicare reassignment NPD
• Childrens Hospital Boston

  • Children's Hospital
  • Boston, MA
  • NPI 1770741530
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1033879986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNIS",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN216459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lynn Geneseo
• Brittany Genest Barrow, PA-C
• Simeret Tsige Genet, MD
• Amy Geng, M.D.
• Dana Gennett, LICSW
• Genoa Healthcare LLC
• Nicole Genovese, PHARMD
• Lorrie Gentes, LICSW
• Alissa Genthon
• Dominic Gentile, MS, CRNA

• Pediatric Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.