Jacquelyn S Stathis, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00814500 Issued in NJ

Practice address

100 E 77TH St
New York, NY 10075-1850

Phone

(212) 434-2000

NPI assigned

Jan 3, 2019

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 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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score

91.02 of 100Reported as group

Quality

93.67

Improvement activities

40

Cost

71.87

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jstathis37810@mskcc.direct-ci.com
• Direct secure messaging: jstathis26083@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• Memorial Developmental Chemo Group

  • Medical Oncology Physician
  • New York, NY
  • NPI 1912978487
  Medicare reassignment NPD
• Memorial Medical Consultation Group

  • Internal Medicine Physician
  • New York, NY
  • NPI 1053382523
  Medicare reassignment NPD
• Memorial Neurology Group

  • Neurology Physician
  • New York, NY
  • NPI 1538130190
  Medicare reassignment NPD
• Memorial Radiation Oncology Group

  • Radiation Oncology Physician
  • New York, NY
  • NPI 1235109224
  Medicare reassignment NPD
• Memorial Solid Tumor Group

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699746172
  Medicare reassignment NPD
• Memorial Urgent Care Group

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1053364539
  Medicare reassignment NPD
• Mskcc Surgery Group

  • Surgical Oncology Physician
  • New York, NY
  • NPI 1699766261
  Medicare reassignment NPD

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

• Lenox Hill Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1477616571
  Care Compare affiliation

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1124591052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHIS",
        "first_name": "JACQUELYN",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00814500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stat Urology Medical Care PLLC
• State of New York Comptrollers Office
• State Wellness Physical Therapy PC
• Staten Island Physician Practice PC
• Statera Psychiatry, P.C.
• Station Physical Therapy
• Station Physical Therapy P.C.
• Maya Jordyn Statmore, LMSW
• Ashley Beth Statter, RD
• Statue TC LLC

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.