Active NPI
Stacey A Carter, PA
- Physician Assistant
- Clifton Park, NY
National Provider Identifier
1902074537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005481
- Practice address
- 2 Roosevelt CT
Clifton Park, NY 12065-6038 - Phone
- (518) 373-8528
- NPI assigned
- Feb 18, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005481 | NY | Primary |
Addresses
Primary practice location
2 Roosevelt CT
Clifton Park, NY 12065-6038
Mailing address
2 Roosevelt CT
Clifton Park, NY 12065-6038
Phone (518) 373-8528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00474072 | Other | NY | RR MEDICARE |
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237420800000",
"number": "1902074537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 ROOSEVELT CT",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120656038",
"telephone_number": "518-373-8528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 ROOSEVELT CT",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120656038",
"telephone_number": "518-373-8528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "STACEY",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-18",
"last_updated": "2009-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005481",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00474072",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.