Individual provider Active NPI

Stacey Susienka Hayward, APRN

  • Family Nurse Practitioner
  • Somers, CT
National Provider Identifier
1154066488
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2261935 Issued in MA
Practice address
6 Heron Dr
Somers, CT 06071-1600
Phone
(508) 887-2199
NPI assigned
May 2, 2022
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2261935 MA Primary

Addresses

Primary practice location

6 Heron Dr
Somers, CT 06071-1600

Mailing address

6 Heron Dr
Somers, CT 06071-1600
Phone (508) 887-2199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220808003140 MA Practitioner - Nurse Practitioner 5597147595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Birnie Ave
Suite 201
Springfield, MA 01107-1121
Phone (714) 785-4666

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2261935MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 1, 2024 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 1, 2024 Accepting new patients
New England Orthopedic Surgeons CurrentSince Aug 15, 2022 Accepting new patients
New England Orthopedic Surgeons CurrentSince Aug 15, 2022 Accepting new patients

Locations

265 Benton Dr
East Longmeadow, MA 01028
Phone (413) 233-1292

265 Benton Dr
Ste 101
East Longmeadow, MA 01028
Phone (714) 785-4666

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1154066488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HERON DR",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060711600",
            "telephone_number": "508-887-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HERON DR",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060711600",
            "telephone_number": "508-887-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "STACEY",
        "middle_name": "SUSIENKA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2261935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, CT

Sources for this page

Verify at the official NPI Registry.