Stacy Sanicola, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

342171 Issued in NY

Practice address

477 Philip Ave
Staten Island, NY 10312-5818

Phone

(917) 295-3957

NPI assigned

Aug 3, 2017

Sex

Female

Sole proprietor

Yes

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

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Weill Cornell Imaging at New York PresbyterianGroup PAC ID 6800986829, 148 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Weill Cornell Imaging at New York Presbyterian

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1447430152
  Medicare reassignment Care Compare group NPD
• Weill Medical College of Cornell

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1538109269
  Medicare reassignment NPD
• Weill Cornell Medical Imaging

  • Body Imaging Physician
  • New York, NY
  • NPI 1417134792
  NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1790200459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 GERVIL ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103094230",
            "telephone_number": "917-295-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 PHILIP AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125818",
            "telephone_number": "917-295-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANICOLA",
        "first_name": "STACY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sangeun Lee, LCSW, Inc
• Max Alfred Sanginario, DPM
• Carla Lynn Sangiorgio, RN
• John Sangiorgio, DVM
• Sangita Parab Medical P.C.
• Victoria Sanicola, SLP
• Jean Marie Sanjurjo, DDS
• Laureano P Sanjurjo, D.D.S.
• Gene Sankin, M.D.
• Mirta C Sanmartin, M.A., LMHC

• Family Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.