Stacey Bryant, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

215935 Issued in MA

Practice address

170 Governors Ave
Hallmark Health System, Inc.
Medford, MA 02155-1643

Phone

(781) 306-6000

Fax

(781) 306-6085

NPI assigned

Jan 9, 2006

Last updated

May 20, 2013By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

360 Healthcare LLCGroup PAC ID 5597131532, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 360 Healthcare LLC

  • Internal Medicine Physician
  • Wilmington, MA
  • NPI 1841919297
  Medicare reassignment Care Compare group NPD
• Melrosewakefield Healthcare, Inc.

  • General Acute Care Hospital
  • Medford, MA
  • NPI 1841290467
  Medicare reassignment NPD
• Hallmark Health System Inc

  • Internal Medicine Physician
  • Medford, MA
  • NPI 1275673667

  Gerontology

  NPD
• Melrosewakefield Healthcare, Inc.

  • Psychiatric Hospital Unit
  • Medford, MA
  • NPI 1891835351
  NPD
• CPL (Glen Ridge) LLC

  dba Glen Ridge Nursing Care Center

  • Skilled Nursing Facility
  • Medford, MA
  • NPI 1760479349
  NPD (past)
• James a Smith & David L Barrasso PTR

  • Geriatric Medicine (Internal Medicine) Physician
  • Medford, MA
  • NPI 1972710515
  NPD (past)
• Tuell Nursing Home Inc.

  • Skilled Nursing Facility
  • Melrose, MA
  • NPI 1124016159
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1376521369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "HALLMARK HEALTH SYSTEM, INC.",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6000",
            "fax_number": "781-306-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "HALLMARK HEALTH SYSTEM, INC.",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6000",
            "fax_number": "781-306-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "STACEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "215935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200992",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Anne Brown-Velazquez, PA-C, MHP
• Holly Brown
• Lorna Brown, PT
• Maren Brown
• Zoe Bryan, LMHC
• Steven Bucchianeri, PHARM.D.
• Stephen Charles Buck, PSY.D.
• Panasaya Buckley, DMD
• Elizabeth Buechler
• Mary Buechler, MD

• Gerontology Nurse Practitioner in Medford, MA
• Providers in Medford, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.