Active NPI
Staci Baranov
- Physician Assistant
- New York, NY
National Provider Identifier
1366097180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 024985
- Practice address
- 731 Lexington Ave
New York, NY 10022-1331 - Phone
- (844) 407-7557
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 024985 | NY | Primary |
Addresses
Primary practice location
731 Lexington Ave
New York, NY 10022-1331
Mailing address
731 Lexington Ave
New York, NY 10022-1331
Phone (844) 407-7557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024985 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Einstein Practice Plan Inc | Past | Accepting new patients | |
| Fornance Physician Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1801853288
-
- Family Medicine Physician
- Norristown, PA
- NPI 1013997386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1366097180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 LEXINGTON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221331",
"telephone_number": "844-407-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 LEXINGTON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221331",
"telephone_number": "844-407-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARANOV",
"first_name": "STACI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-08",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "024985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.