NPIMap

Individual provider Active NPI

Stacey E Pynn, PA

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1154355501
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006987-1 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone
(716) 845-2300
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006987-1 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-0001

Mailing address

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other identifiers 1

IdentifierTypeStateIssuer
01957120MedicaidNY

Other names 1

  • Stacey Sonnelitter Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000348 NY Practitioner - Physician Assistant 3476500471 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
77.37
Promoting interoperability
99
Improvement activities
40
Cost
71.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006987NYMDMental Health Counselor
006987-1NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Apr 1, 2024 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Keystone Medical Services of Niagara Falls PC Past Accepting new patients
Niagara Hospitalist, PC Past Accepting new patients
Ipc Hospitalist Services of New York, P.C. Past Accepting new patients
New York Physician Medical Services, PLLC Past Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1154355501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYNN",
        "first_name": "STACEY",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006987-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01957120",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SONNELITTER",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.