Stephanie Nucci II, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

009608 Issued in NY

Practice address

635 Belle Terre Rd
Suite #204
Port Jefferson, NY 11777-1935

Phone

(631) 474-0008

Fax

(631) 474-0224

NPI assigned

Nov 19, 2007

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

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PC 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles (4 of 8)

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  NY

  Medicare reassignment Care Compare group
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Emergency Medicine Physicians of Suffolk County, PLLC

  • Emergency Medicine Physician
  • East Patchogue, NY
  • NPI 1669783924
  NPD (past)
• Mendelsohn Medical, PLLC

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1437578127
  NPD (past)
• PJS Medical Diagnostic PLLC

  • Diagnostic Radiology Physician
  • Port Jefferson Station, NY
  • NPI 1609110295
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Shore University Hospital

  • General Acute Care Hospital
  • Bay Shore, NY
  • NPI 1457369381

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1629259668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "SUITE #204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935",
            "telephone_number": "631-474-0008",
            "fax_number": "631-474-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "SUITE #204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935",
            "telephone_number": "631-474-0008",
            "fax_number": "631-474-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCCI",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Shore Hematology Oncology Associates PC
• North Shore Procedures, LLC
• North Shore Pulmonary Assoc LLP
• North Shore Vascular Surgery, PC
• North Suffolk Surgical Assoc
• Nurse Practitioner Infant and Child Healthcare, PC
• Benjamin O'Brien
• Marie O'Brien, ANP
• Aimee Lorraine O'Connell
• Kevin M O'Connell, OTR

• All providers in Port Jefferson, NY
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.