Individual provider Active NPI

Stacey Brosnan, NP, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • East Hampton, NY
National Provider Identifier
1194803510
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
F360388 Issued in NY
Practice address
200 Pantigo PL Ste N
East Hampton, NY 11937-5923
Phone
(631) 329-6500
Fax
(631) 759-9429
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 000345 NY
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F360388 NY Primary

Addresses

Primary practice location

200 Pantigo PL Ste N
East Hampton, NY 11937-5923

Mailing address

PO Box 31218
Hartford, CT 06150-1218
Phone (914) 328-4500

Other identifiers 1

IdentifierTypeStateIssuer
1815732MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251229002032 NY Practitioner - Nurse Practitioner 0840288841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

200 Pantigo PL
Suite N
East Hampton, NY 11937-5923
Phone (631) 329-6500

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F360388NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC CurrentSince Dec 22, 2025 Accepting new patients
OBGYN Associates at Lich Past Accepting new patients
OB GYN Associates at Long Island College Hospital Past Accepting new patients
Eastern Suffolk Urology PC PastSince Jun 15, 2013 Accepting new patients

Locations

200 Pantigo Pl
East Hampton, NY 11937
Phone (631) 267-6969

200 Pantigo Pl
Ste N
East Hampton, NY 11937
Phone (631) 329-6500

117 Hampton Rd
Southampton, NY 11968
Phone (631) 287-8600

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

Interoperability endpoints

  • Direct secure messaging: stacey.brosnan@sbcm.cernerdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1194803510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31218",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061501218",
            "telephone_number": "914-328-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PANTIGO PL STE N",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119375923",
            "telephone_number": "631-329-6500",
            "fax_number": "631-759-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSNAN",
        "first_name": "STACEY",
        "credential": "NP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "000345",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F360388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1815732",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hampton, NY

Sources for this page

Verify at the official NPI Registry.