Individual provider Active NPI

Nicole Stoppelli, PA STUDENT

  • Physician Assistant
  • Lindenhurst, NY
National Provider Identifier
1487313714
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
305 N Greene Ave
Lindenhurst, NY 11757-3862
Phone
(631) 943-1147
NPI assigned
Dec 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

305 N Greene Ave
Lindenhurst, NY 11757-3862

Mailing address

305 N Greene Ave
Lindenhurst, NY 11757-3862
Phone (631) 943-1147

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
I20220509002341 NY Practitioner - Physician Assistant 8820475049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aesthetic Plastic Surgery PCGroup PAC ID 7012924939, 10 clinicians

Practice addresses (Care Compare)

833 Northern Blvd
Suite 160
Great Neck, NY 11021-5322
Phone (516) 498-8400

Hospital & facility affiliations

  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Cardiovascular Anesthesiologists, P.C. PastSince Aug 11, 2025 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.

Hospital & facility affiliations 4

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1487313714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N GREENE AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573862",
            "telephone_number": "631-943-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N GREENE AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573862",
            "telephone_number": "631-943-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOPPELLI",
        "first_name": "NICOLE",
        "credential": "PA STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.