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Individual provider Active NPI

Stacey Ann Laurito, PAC

  • Physician Assistant
  • Trenton, NJ
National Provider Identifier
1114980729
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00096900 Issued in NJ
Practice address
1 Hamilton Health PL
Trenton, NJ 08690-3542
Phone
(609) 585-1122
Fax
(215) 949-2384
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010906 NY
Physician Assistant 363A00000X 004835 GA
Physician Assistant 363A00000X 25MP00096900 NJ Primary

Addresses

Primary practice location

1 Hamilton Health PL
Trenton, NJ 08690-3542

Mailing address

PO Box 7410723
Chicago, IL 60674-0723
Phone (609) 585-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, GA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040804000927 NJ Practitioner - Physician Assistant 5294706032 Reassigns benefits to 4 organizations
I20060907000391 NY Practitioner - Physician Assistant 5294706032 Reassigns benefits to 4 organizations
I20070410000087 GA Practitioner - Physician Assistant 5294706032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians
Peyman Younesi MD PLLCGroup PAC ID 4981860202, 98 clinicians

Practice addresses (Care Compare)

2 University PLZ
Suite 204
Hackensack, NJ 07601-6211
Phone (973) 241-1356

8008 45TH Ave
Elmhurst, NY 11373-3545
Phone (347) 709-3133

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Whiting, NJ, CCN 317031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
010906NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC NJ III PC CurrentSince Mar 9, 2026 Accepting new patients
Ennoble HC NJ II PC CurrentSince Mar 9, 2026 Accepting new patients
Ennoble HC NJ PC CurrentSince Mar 9, 2026 Accepting new patients
Teaneck Emergency Physicians PA Past Accepting new patients

Locations

50 Glenlake Pkwy
Ste 420
Sandy Springs, GA 30328
Phone (404) 595-2210

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

1000 Haddonfield Berlin Rd
Ste 205
Voorhees, NJ 08043
Phone (973) 241-1356

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1114980729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7410723",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740723",
            "telephone_number": "609-585-1122",
            "fax_number": "215-949-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAMILTON HEALTH PL",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086903542",
            "telephone_number": "609-585-1122",
            "fax_number": "215-949-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURITO",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004835",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00096900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.