Theresa Lorraine Stavola, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

301910 Issued in NY

Practice address

HSC T16-080 Nicholls Rd Dept of Internal Medicine
Div of Cardiology Suny Stony Brook University Hospital
Stony Brook, NY 11794

Phone

(631) 444-1066

NPI assigned

Sep 15, 2008

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: theresa.stavola@direct.stonybrookmedicine.edu

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.

• Family Service League, Inc.

  • Community/Behavioral Health Agency
  • Huntington, NY
  • NPI 1528093242
  Medicare reassignment

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1801045984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC T16-080 NICHOLLS RD DEPT OF INTERNAL MEDICINE",
            "address_2": "DIV OF CARDIOLOGY SUNY STONY BROOK UNIVERSITY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC T16-080 NICHOLLS RD DEPT OF INTERNAL MEDICINE",
            "address_2": "DIV OF CARDIOLOGY SUNY STONY BROOK UNIVERSITY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVOLA",
        "first_name": "THERESA",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of New York Comptrollers Office
• State of New York Comptrollers Office
• State of New York Comptrollers Office
• State of New York Comptrollers Office
• Matthew Statz, MD
• Micah Steele
• Kamil Stefanowski, M.D.
• Amy Wishner Steinberg, MD
• Ellen Steinberg, M.D.
• Daniel Richard Steiner

• Adult Health Nurse Practitioner in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.