Individual provider Active NPI

Stephanie Pantelidis

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1649152935
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357492 Issued in NY
Practice address
101 Pennsylvania Ave
Brooklyn, NY 11207-2428
Phone
(718) 732-4049
NPI assigned
Jul 25, 2025
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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 357492 NY Primary

Addresses

Primary practice location

101 Pennsylvania Ave
Brooklyn, NY 11207-2428

Mailing address

1 Research Rd
Ridge, NY 11961-2701

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Other practice location 2

447 Atlantic Ave
Brooklyn, NY 11217-1702
Phone (718) 732-4049

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
I20251230001872 NY Practitioner - Nurse Practitioner 6507352465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
357492NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Oct 24, 2025 Accepting new patients

Locations

447 Atlantic Ave
Brooklyn, NY 11217
Phone (718) 421-2131

101 Pennsylvania Ave
Brooklyn, NY 11207
Phone (718) 240-2000

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1 Research Rd
Ridge, NY 11961

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1649152935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RESEARCH RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072428",
            "telephone_number": "718-732-4049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112171702",
            "country_code": "US",
            "telephone_number": "718-732-4049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTELIDIS",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.