Stacyann M Evans

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F353349-01 Issued in NY

Practice address

160 Beachview St
Copiague, NY 11726-3602

Phone

(631) 464-1497

NPI assigned

Mar 11, 2024

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Island Select Healthcare, IncGroup PAC ID 5991086225, 29 clinicians

New York Pain Consultants LLCGroup PAC ID 0749260107, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107

  NY

  Medicare reassignment Care Compare group NPD
• New York Pain Consultants LLC

  • Interventional Pain Medicine Physician
  • Babylon, NY
  • NPI 1639190630

  NY

  Medicare reassignment Care Compare group NPD
• Bronx Medical Practice P.C.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1356726087

  NY

  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709

  NY

  Medicare reassignment NPD
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946

  NY

  Medicare reassignment NPD
• Mill Basin Medical Health PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346006202

  NY

  Medicare reassignment NPD
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  NY

  Medicare reassignment NPD
• New York Pain Consultants LLC

  • Interventional Pain Medicine Physician
  • Harrison, NY
  • NPI 1528617917
  Care Compare group NPD
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Riverhead, NY
  • NPI 1295188357
  Care Compare group
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Port Jefferson Station, NY
  • NPI 1417300575
  Care Compare group
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Smithtown, NY
  • NPI 1447603501
  Care Compare group
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manorville, NY
  • NPI 1518310689
  Care Compare group

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1295593663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BEACHVIEW ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263602",
            "telephone_number": "631-464-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BEACHVIEW ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263602",
            "telephone_number": "631-464-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "STACYANN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353349-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Eisele, LMSW
• Mary Elizabeth Elliott, LPN
• Theresa Marie Elliott, LPN
• Alyson Marie Esposito, D.D.S.
• Anne-Elie Etienne, LPN
• Ewa Zysk Dentistry P.C.
• Faiq Dentistry PC
• Mariam Faiq, DDS
• Eric Falkman, LMSW
• Family Wellness Chiropractic, PC

• All providers in Copiague, NY
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.