Individual provider Active NPI

Stacy H Schoenbach, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Melville, NY
National Provider Identifier
1073037032
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402177-1 Issued in NY
Practice address
200 Broadhollow Road
Suite 207
Melville, NY 11747
Phone
(631) 707-2394
Fax
(631) 824-9118
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402177-1 NY Primary

Addresses

Primary practice location

200 Broadhollow Road
Suite 207
Melville, NY 11747

Mailing address

200 Broadhollow Rd Ste 207
Melville, NY 11747-4806
Phone (631) 707-2394

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171218000219 NY Practitioner - Nurse Practitioner 0042578486 Reassigns benefits to 2 organizations
I20260303001106 FL Practitioner - Nurse Practitioner 0042578486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 Broadhollow Rd
Suite 207
Melville, NY 11747-4806
Phone (631) 707-2394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F402177-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stacy Schoenbach, Nurse Practitioner Psychiatric Services PC Psychiatric/Mental Health CurrentSince Jul 1, 2023 Accepting new patients
Eastport Behavioral Health & Psychiatry LLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients
Focus Mental Health Solutions of Long Island, Inc. Psychiatric/Mental Health CurrentSince Nov 1, 2017 Accepting new patients

Locations

200 Broadhollow Rd
Ste 207
Melville, NY 11747
Phone (516) 906-4970

150 Broadhollow Rd
Ste 310
Melville, NY 11747
Phone (516) 882-4544

Organizations & group practices 3

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": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1073037032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BROADHOLLOW RD STE 207",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474806",
            "telephone_number": "631-707-2394",
            "fax_number": "631-824-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BROADHOLLOW ROAD",
            "address_2": "SUITE 207",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-707-2394",
            "fax_number": "631-824-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBACH",
        "first_name": "STACY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2023-07-10",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402177-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.