Individual provider Active NPI

Stacia Beth Birdsall, CNM

  • Advanced Practice Midwife
  • New York, NY
National Provider Identifier
1174629778
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F001385-1 Issued in NY
Practice address
268 Canal St
New York, NY 10013-3599
Phone
(212) 966-0228
Fax
(212) 966-9330
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F001385-1 NY Primary

Addresses

Primary practice location

268 Canal St
New York, NY 10013-3599

Mailing address

125 Walker St FL 2
New York, NY 10013-4135
Phone (212) 226-8866

Other identifiers 1

IdentifierTypeStateIssuer
03338112MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000301CTMDAthletic Trainer
F001385-1NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Faculty Physicians Past Accepting new patients
Charles B. Wang Community Health Center, Inc. PastSince Jul 25, 2019 Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: sbirdsall787940@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1174629778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133599",
            "telephone_number": "212-966-0228",
            "fax_number": "212-966-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDSALL",
        "first_name": "STACIA",
        "middle_name": "BETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F001385-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03338112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.