Stacey Louise Mazzacco, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD053932L Issued in PA

Practice address

2104 Harrisburg Pike
Ste 200
Lancaster, PA 17601-2644

Phone

(717) 544-3626

Fax

(717) 544-3628

NPI assigned

Nov 8, 2005

Last updated

Sep 30, 2020By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Vascular SurgeryAlso: General Surgery

Education

Temple University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smazzacco10620@direct-lghealth.org

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.

• Lancaster General Medical Group

  dba Penn Medicine LGHP Behavioral Health

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1952392383
  Medicare reassignment Care Compare group NPD
• Lancaster General Hospital

  dba Penn Medicine LGHP Trauma & Acute Care Surgery

  • Surgery Physician
  • Lancaster, PA
  • NPI 1154331775
  Medicare reassignment NPD
• Lancaster Surgical Group PC

  • Surgery Physician
  • Lancaster, PA
  • NPI 1851341838
  NPD (past) Authorized official
• Lanaster General Hospital

  dba Penn Medicine Lancaster General Health Pain Care

  • Anesthesiology Physician
  • Lancaster, PA
  • NPI 1144741901
  NPD
• Lancaster General Hospital

  dba Penn Medicine LG Health Physicians Gastrointestinal Services

  • Gastroenterology Physician
  • Lancaster, PA
  • NPI 1205691912
  NPD
• Lancaster General Medical Group

  • Obstetrics & Gynecology Physician
  • Lancaster, PA
  • NPI 1306724570
  NPD
• Lancaster General Medical Group

  dba Penn Medicine LGHP NeuroScience & Spine Associates

  • Neurological Surgery Physician
  • Lancaster, PA
  • NPI 1679049787
  NPD
• Lancaster General Medical Group

  dba Penn Medicine LGHP Family Medicine East Petersburg

  • Family Medicine Physician
  • East Petersburg, PA
  • NPI 1083600290
  NPD (past)
• Lancaster General Medical Group

  dba Penn Medicine LGHP Family Medicine Strasburg

  • Family Medicine Physician
  • Strasburg, PA
  • NPI 1316912785
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lancaster General Hospital

  • General Acute Care Hospital
  • Lancaster, PA
  • NPI 1104875103
  Care Compare affiliation
• Lancaster General Hospital

  dba Parkesburg Outpatient Center

  • General Acute Care Hospital
  • Parkesburg, PA
  • NPI 1245571942
  Care Compare affiliation
• Lancaster General Hospital

  • Ambulatory Surgical Clinic/Center
  • Lancaster, PA
  • NPI 1538290424

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1265413207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 HARRISBURG PIKE STE 200",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3626",
            "fax_number": "717-544-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 HARRISBURG PIKE",
            "address_2": "STE 200",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3626",
            "fax_number": "717-544-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZACCO",
        "first_name": "STACEY",
        "middle_name": "LOUISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD053932L",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD053932L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0178844",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020048899",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn R Maz, PSY D
• Michael Mazanek
• Kevin Mazariegos
• Eileen Mazeski, LPN
• Anne Wairimu Mazza
• Mary Chaplin Mazzocchi, MS, RD, LDN, NBC-HWC
• Christina Mazzone, D.M.D.
• Leonie Mbiekop, CRNP
• Eamonn McAteer
• Taisa McCain

• Vascular Surgery Physician in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.