Stacy Lynn Entin, PHYSICIAN ASST.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

009989-1 Issued in NY

Practice address

79 Grand Ave
Massapequa, NY 11758

Phone

(516) 798-3376

Fax

(516) 798-5882

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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

Credentials

Physician Assistant

State licenses

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.

• Irwin Goldstein, M.D.

  • Obstetrics & Gynecology Physician
  • Massapequa, NY
  • NPI 1366528127
  Medicare reassignment

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1851459820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 CANDEE AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823059",
            "telephone_number": "631-750-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 GRAND AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-798-3376",
            "fax_number": "516-798-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTIN",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASST.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009989-1",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "009989-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Elie Pierre
• Emerge Yoga & Wellness (Emerge Integrative Wellness)
• Kristin English, MD
• Eninnaj Skin & Body LLC
• Kim Louise Enoksen, CCC-SLP
• Walter Ira Epstein, DDS
• Ernie Eisenberg DC PC (Good Health Chiropractic)
• Christina Lynn Errichiello, PA-C
• Teresa Esposito, DO
• Courtney Evans-Wall, LMT

• Physician Assistant in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.