Sophia Staley

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

F432146-01 Issued in NY

Practice address

6716 Parsons Blvd Apt 6C
Flushing, NY 11365-2958

Phone

(718) 591-5308

NPI assigned

Sep 26, 2021

Last updated

Sep 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

New York Medical and Diagnostic Center IncGroup PAC ID 9436041217, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• New York Medical & Diagnostic Center Inc

  • Family Medicine Physician
  • Kew Gardens, NY
  • NPI 1790771889
  Medicare reassignment Care Compare group NPD
• The Queens NP Acute Care P.C.

  • Internal Medicine Physician
  • Fresh Meadows, NY
  • NPI 1750266292
  Medicare reassignment NPD Authorized official
• Sante Professional Corporation

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1770314965
  NPD Authorized official

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

{
    "created_epoch": "1632614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632614400000",
    "number": "1205507597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6716 PARSONS BLVD APT 6C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113652958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6716 PARSONS BLVD APT 6C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113652958",
            "telephone_number": "718-591-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-26",
        "last_updated": "2021-09-26",
        "certification_date": "2021-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NY",
            "license": "F432146-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andre Frantz St Preux Dabel, M.A.,M.S.E.D.,L.P.C.
• St. John's University Center for Psychological Services
• Nicoletta Stagias- Coulianidis, M.A., CCC- SLP
• Ashleigh Stahl
• Margaret Staiano, PH.D.
• Deemah Stalhamer, D.O.
• Stan Acupuncture PC
• Stand-Up MRI of Queens, P.C.
• Stanford Medical P.C.
• Stanley-Sangwook Kim D.O. PC

• Critical Care Medicine Nurse Practitioner in Flushing, NY
• Providers in Flushing, NY by specialty
• Critical Care Medicine Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2021; 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.