Individual provider Active NPI

Lydia Sutton Staiger, FNP

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1477047504
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343162 Issued in NY
Practice address
3327 Brighton Blvd
Denver, CO 80216-5020
Phone
(415) 663-5584
Fax
(844) 640-3975
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343162 NY Primary

Addresses

Primary practice location

3327 Brighton Blvd
Denver, CO 80216-5020

Mailing address

555 Bryant St Ste 814
Palo Alto, CA 94301-1704

Other practice location 1

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4011

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180904002672 NY Practitioner - Nurse Practitioner 7315297819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ruby Medical PCGroup PAC ID 0446753297, 6 clinicians

Practice addresses (Care Compare)

12 W 120TH St
New York, NY 10027-6308
Phone (914) 461-5607

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
343162NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Associates, PC CurrentSince Sep 15, 2018 Accepting new patients
Alpha Telemedicine, PC PastSince Mar 5, 2023 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: lydia.staiger.1@20088.direct.athenahealth.com
  • Direct secure messaging: lydia.staiger.1@17222.direct.athenahealth.com

Organizations & group practices 3

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1477047504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRYANT ST STE 814",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 BRIGHTON BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802165020",
            "telephone_number": "415-663-5584",
            "fax_number": "844-640-3975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dates Dr",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501342",
            "country_code": "US",
            "telephone_number": "607-274-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAIGER",
        "first_name": "LYDIA",
        "middle_name": "SUTTON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2023-03-02",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.