Active NPI
Staci L Levick
- Otolaryngology Physician
- Norristown, PA
National Provider Identifier
1669556171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- OSD07490L
- Practice address
- 60 W Germantown Pike
Norristown, PA 19401 - Phone
- (610) 279-1414
- Fax
- (610) 279-4725
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | OSD07490L | PA | Primary |
Addresses
Primary practice location
60 W Germantown Pike
Norristown, PA 19401
Mailing address
60 W Germantown Pike
Norristown, PA 19401
Phone (610) 279-1414
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001600189002 | Medicaid | PA | |
| 783840 | Other | BLUE SHIELD OF PA | |
| 1044866 | Other | PA | KEYSTONE MERCY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OSD07490L | PA | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berger Henry ENT Specialty Group | Otolaryngology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Otolaryngology Physician
- Norristown, PA
- NPI 1437220050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669556171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 W GERMANTOWN PIKE",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "19401",
"telephone_number": "610-279-1414",
"fax_number": "610-279-4725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 W GERMANTOWN PIKE",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "19401",
"telephone_number": "610-279-1414",
"fax_number": "610-279-4725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVICK",
"first_name": "STACI",
"middle_name": "L",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "PA",
"license": "OSD07490L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001600189002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF PA",
"identifier": "783840",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "1044866",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norristown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.