Individual provider Active NPI

Theresa M Stapon, CRNA

  • Certified Registered Nurse Anesthetist
  • Rocky Point, NY
National Provider Identifier
1275556359
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
396369-1 Issued in NY
Practice address
333 Route 25a Ste 225
Rocky Point, NY 11778-8802
Phone
(631) 744-0396
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered Nurse 163WP0000X 396369-1 NY
Certified Registered Nurse Anesthetist 367500000X 396369-1 NY Primary

Addresses

Primary practice location

333 Route 25a Ste 225
Rocky Point, NY 11778-8802

Mailing address

333 Route 25a Ste 225
Rocky Point, NY 11778-8802
Phone (631) 744-0396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001598 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678561917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
396369-1NYMDPain Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Jan 1, 1998 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Jan 30, 2023 Accepting new patients
New York University Current Accepting new patients
Peconic Anesthesiologist, P.C. Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1275556359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A STE 225",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788802",
            "telephone_number": "631-744-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A STE 225",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788802",
            "telephone_number": "631-744-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPON",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "NY",
            "license": "396369-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "396369-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.