Active NPI
Jaclyn Anne Nunez Sta. Maria, MD
- Family Medicine Physician
- West Nyack, NY
National Provider Identifier
1740625631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 276147
- Practice address
- 2 Centerock Rd
West Nyack, NY 10994-2215 - Phone
- (845) 703-6999
- Fax
- (845) 703-6297
- NPI assigned
- May 6, 2013
- Last updated
- Oct 16, 2020
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 276147 | NY | Primary |
Addresses
Primary practice location
2 Centerock Rd
West Nyack, NY 10994-2215
Mailing address
155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03917599 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jaclynanne.stamariamd.p1@direct.crystalrun.nextgenshare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391
Hospital & facility affiliations
- Valley Home Care Inc.
- Adoration Home Health
- Valley Hospital
- Chilton Medical Center
- St Joseph's University Medical Center Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.05 of 100
- Quality
- 85.71
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 276147 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Physician Services PC | Current | Accepting new patients |
Locations
223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417
Interoperability endpoints
- jaclyn.anne.sta.maria.1@5622.direct.athenahealth.com
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.
-
- Internal Medicine Physician
- Paramus, NJ
- NPI 1467815928
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Chilton Medical Center
- General Acute Care Hospital
- Pompton Plains, NJ
- NPI 1811994809
-
dba Patient Care
- Community Based Hospice Care Agency
- Passaic, NJ
- NPI 1144280017
Home health agency
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
-
- General Acute Care Hospital
- Paramus, NJ
- NPI 1013912633
-
- Home Health Agency
- Paramus, NJ
- NPI 1174588925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1740625631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 CRYSTAL RUN RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109414028",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CENTEROCK RD",
"city": "WEST NYACK",
"state": "NY",
"postal_code": "109942215",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STA. MARIA",
"first_name": "JACLYN ANNE",
"middle_name": "NUNEZ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-06",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "276147",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03917599",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jaclynanne.stamariamd.p1@direct.crystalrun.nextgenshare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2 Centerock Rd",
"city": "West Nyack",
"state": "NY",
"country_code": "US",
"postal_code": "109942215",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.