Active NPI
Stacy Brianne Robustelli, PA-C
- Physician Assistant
- Abington, PA
National Provider Identifier
1083469977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1200 Old York Road
Abington, PA 19001 - Phone
- (215) 802-4375
- NPI assigned
- Apr 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1200 Old York Road
Abington, PA 19001
Mailing address
1200 Old York Rd
Abington, PA 19001-3314
Phone (215) 802-4375
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251001003550 | PA | Order and Referring Only - Physician Assistant | 0345746046 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1083469977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 OLD YORK RD",
"city": "ABINGTON",
"state": "PA",
"postal_code": "190013314",
"telephone_number": "215-802-4375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 OLD YORK ROAD",
"city": "ABINGTON",
"state": "PA",
"postal_code": "19001",
"telephone_number": "215-802-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBUSTELLI",
"first_name": "STACY",
"middle_name": "BRIANNE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-23",
"last_updated": "2024-10-25",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.