Stacie S Diaz, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

022590 Issued in NY

Practice address

17224 133Rd Ave Apt 11E
Jamaica, NY 11434-3903

Phone

(917) 400-1294

NPI assigned

Jul 2, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chenaniah Whole Healing, LLC

  • Massage Therapist
  • Jamaica, NY
  • NPI 1447014428
  NPD Authorized official
• Zen & Body LLC

  • Point of Service
  • Lynbrook, NY
  • NPI 1073632105
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1215166830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 133RD AVE",
            "address_2": "SUITE 11E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343955",
            "telephone_number": "917-400-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 133RD AVE APT 11E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343903",
            "telephone_number": "917-400-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Taft Ave",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115631403",
            "country_code": "US",
            "telephone_number": "516-596-9100",
            "fax_number": "516-515-4331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "STACIE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "022590",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "022590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viviane Diaquoi
• Ndeye Kane Diaw
• Michelle Diaz-Gautreau
• Chloe Nicole Diaz, LMSW
• Richard Alexander Diaz
• Vladimir Diaz
• Pauletta Dickerson, LPN, RN
• Donna L Dickson
• Rhonda Carla Diener, MA CCC/SLP
• Billy Diep, RPH

• Massage Therapist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.