Stacey Michelle Cook, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

018439 Issued in NY

Practice address

4939 Brittonfield Pkwy
Suite 101
East Syracuse, NY 13057-9208

Phone

(315) 463-1600

Fax

(315) 634-6793

NPI assigned

Feb 11, 2015

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

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

Physician Assistant

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.

• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Oswego, NY
  • NPI 1134370547
  Medicare reassignment
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment
• St. Joseph'S Physician Health, P.C.

  • Anesthesiology Physician
  • Troy, NY
  • NPI 1154376770
  Medicare reassignment
• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162
  Medicare reassignment
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Hamilton, NY
  • NPI 1316395460

  Physician Assistant

  NPD
• Skaneateles Spine & Sport, Inc.

  • Physical Therapist
  • Skaneateles, NY
  • NPI 1396845244
  NPD (past)
• William a Graber MD PC

  • Surgery Physician
  • Utica, NY
  • NPI 1093956682
  NPD (past)

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1265823306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "address_2": "SUITE 101",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-463-1600",
            "fax_number": "315-634-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "address_2": "SUITE 101",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-463-1600",
            "fax_number": "315-634-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connect Marriage and Family Therapy Services
• Elizabeth Connelly, NP
• Ryan Connolly, PA
• Carrie Besth Conway, TEACHER
• Madison Kennedy Walsh Cook, MS, CF-SLP
• Derek Robert Cooney, MD
• Kayla Mary Cornell, FNP
• Gina Marie Corona, LCSW-R
• Kayla Corron, LPN
• Sarah Whitney Covell

• Physician Assistant in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.