Stacey Espaillat, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD454665 Issued in PA

Practice address

1107 Eaton Ave
Bethlehem, PA 18018-1862

Phone

(484) 526-2400

Fax

(484) 526-3697

NPI assigned

May 20, 2010

Last updated

Aug 18, 2015By 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 2

Addresses

Other names 1

• Stacey Hauber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1609195387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 EATON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181862",
            "telephone_number": "484-526-2400",
            "fax_number": "484-526-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 EATON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181862",
            "telephone_number": "484-526-2400",
            "fax_number": "484-526-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPAILLAT",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME117544",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD454665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "HAUBER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Jay Esbenshade, M.D.
• Vanessa Esbri, FNP-C
• Erica Escarcega, M.D.
• Jennifer Farber Eschbach, NP
• Jane Escott, RN
• Tamara Nichole Esperias
• Jessica Espino, LCSW
• Ronald Joseph Esteve, PH.D.
• Haided Estevez
• Linda Nkoumba Eteki, LSW

• Psychiatry Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.