Individual provider Active NPI

Stacy-Ann T Thomas-Leslie, FNP, PMHNP

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1265953723
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017443 Issued in PA
Practice address
510 E Baltimore Pike
Media, PA 19063-3836
Phone
(610) 566-3218
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017443 PA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SPO32164 PA

Addresses

Primary practice location

510 E Baltimore Pike
Media, PA 19063-3836

Mailing address

503 Emerson Ave
Lansdowne, PA 19050-2509
Phone (610) 733-2598

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171107003439 PA Practitioner - Nurse Practitioner 1759647753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

1900 N 20TH St
Health Care Ctr 5
Philadelphia, PA 19121-2217
Phone (215) 685-2973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP017443PAMDFamily Nurse Practitioner
SPO32164PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Feb 12, 2018 Accepting new patients
City of Philadelphia CurrentSince Feb 12, 2018 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

1900 N 20th St
#5
Philadelphia, PA 19121
Phone (215) 685-2933

1101 Market St
Fl 10
Philadelphia, PA 19107

1900 N 20th St
Philadelphia, PA 19121
Phone (215) 685-2933

Interoperability endpoints

  • Direct secure messaging: stacyann.thomas@pdphahs.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1265953723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 EMERSON AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190502509",
            "telephone_number": "610-733-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633836",
            "telephone_number": "610-566-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-LESLIE",
        "first_name": "STACY-ANN",
        "middle_name": "T",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017443",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SPO32164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.