Stacey A Pendell, PNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F381553 Issued in NY

Practice address

10 - 42 Mitchell Avenue
Binghamton, NY 13903

Phone

(607) 762-2468

Fax

(607) 762-3871

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacey A Stalter Former name

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

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 and National Provider Directory roles.

• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment NPD
• United Medical Associates PC

  • Clinic/Center
  • Binghamton, NY
  • NPI 1013972801
  Medicare reassignment NPD
• United Medical Associates, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Binghamton, NY
  • NPI 1629252556
  NPD

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1245386317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-762-2468",
            "fax_number": "607-762-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 - 42 MITCHELL AVENUE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13903",
            "telephone_number": "607-762-2468",
            "fax_number": "607-762-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDELL",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "PNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03018146",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "STALTER",
            "middle_name": "A",
            "credential": "PNC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Desiree Peavy-McClintock
• Holly Joy Peck, PMHNP
• Pediatric Physical Therapy Services
• Jonathan James Pelc
• Theresa Pelzel Poklemba, PHARMD
• Penn York Medical Supplies Inc.
• Shawn Michael Pepples, CASAC-T
• Melanie B Peranich, RD, CDN, CDE
• Doris Belle Pereske, A.C.S.W.
• Signa Latoya Perkins, MD

• Pediatric Nurse Practitioner in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.