Individual provider Active NPI

Stacy Ormond, PAC

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1043485485
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007703 Issued in NY
Practice address
2066 Hudson Ave
Rochester, NY 14617-4300
Phone
(585) 922-2800
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007703 NY Primary

Addresses

Primary practice location

2066 Hudson Ave
Rochester, NY 14617-4300

Mailing address

2066 Hudson Ave
Rochester, NY 14617-4300
Phone (585) 922-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160916001750 NY Practitioner - Physician Assistant 4486941598 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007703NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jun 25, 2016 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Jun 25, 2016 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jun 25, 2016 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1043485485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174300",
            "telephone_number": "585-922-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174300",
            "telephone_number": "585-922-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORMOND",
        "first_name": "STACY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.