Stacia Stickney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2361 Issued in ME

Practice address

1420 Main St
Sanford, ME 04073-3680

Phone

(207) 850-5744

NPI assigned

May 20, 2015

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Brockton, MA
  • NPI 1932942869
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Littleton, NH
  • NPI 1982395315
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sanford, ME
  • NPI 1821789363
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Newburyport, MA
  • NPI 1316428824
  NPD (past)

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1215316468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 MAIN ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040733680",
            "telephone_number": "207-850-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "STACIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6058",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris C Sparks, RN
• Lindsey D Sprague, PA
• William Steele, LMT
• Janet S Steffens, M.S.CCC
• Stepping Forward Physical Therapy LLC
• Strength for Tomorrow LLC
• Paul J Sturmer, PHD
• Laura Ruth Sugrue, MSPT, OCS
• Jordyn Lebrun Sullivan, PHARMD
• Julee Cay Supan-Mathieu

• Physician Assistant in Sanford, ME
• Providers in Sanford, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.