STACEY DIGIACOMO (NPI# 1023233103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023233103 |
| Entity Type | Individual |
| Full Name | STACEY DIGIACOMO |
| Credential | P.A. |
| Practice Address |
4 Roosevelt Ave Port Jefferson Station NY 11776-3363 |
| Mailing Address |
900 Merchants Concourse Ste 216 Westbury NY 11590-5114 |
| Practice Telephone | 6313310500 |
| Practice Fax Number | 6313311644 |
| Mailing Telephone | 5162268373 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 007238 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4 ROOSEVELT AVE |
| City | PORT JEFFERSON STATION |
| State | NY |
| Zip Code | 11776-3363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457350795 | Jerry Ninia | Obstetrics & Gynecology | 4 Roosevelt Ave, Port Jefferson Station, NY 11776-3363 | 2005-07-19 |
| 1225253222 | Cecilia Vanisky | Nurse Practitioner | 4 Roosevelt Ave, Port Jefferson Station, NY 11776-3363 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205304219 | Melissa E Germano | Acupuncturist | 5225 Nesconset Highway Rte 347, Davis Professional Park Building 1 Suite 1, Port Jefferson Station, NY 11776 | 2018-11-07 |
| 1366962185 | Michael Louis Scicchitano Sr. | Physical Therapist | 3 Colgate Street, Port Jefferson Station, NY 11776 | 2017-06-22 |
| 1063969517 | Dana Adamkiewicz | Acupuncturist | 432 North Bicycle Path, Port Jefferson Station, NY 11776 | 2016-09-01 |
| 1538531819 | Jacqueline Rambo | Specialist | 5225 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2015-10-26 |
| 1821474297 | Michael Leuci | Social Worker | 3 Premier Court, Port Jefferson Station, NY 11776 | 2015-08-07 |
| 1578978078 | Carol A. Palmer I | Acupuncturist | 34 Champlain St, Port Jefferson Station, NY 11776 | 2014-06-24 |
| 1659783371 | Janette M Sperandeo | Nurse Practitioner | 5 Roosevelt Avenue, Port Jefferson Station, NY 11776 | 2014-05-29 |
| 1578973079 | James Buchrieser | Specialist | 525 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2014-05-06 |
| 1871923227 | Duran Thomas Murphy | Licensed Practical Nurse | 8 Carolyn Road, Port Jefferson Station, NY 11776 | 2013-11-22 |
| 1699104562 | Julio Genao | Massage Therapist | 213 Jayne Blvd, Portjefferson Station, NY 11776 | 2013-11-01 |
| Find all providers in zip 11776 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387829 | Jesse Inkles | Physician Assistant | 6 Foxrun Ct, Port Jefferson Station, NY 11776-1386 | 2020-08-19 |
| 1104443985 | Nicole Renee Driscoll | Physician Assistant | 34 Parkridge Cir, Port Jefferson Station, NY 11776-3419 | 2020-06-29 |
| 1508341751 | John Paul Delirio | Physician Assistant | 6 Fairway Dr, Port Jefferson Station, NY 11776-3604 | 2018-10-03 |
| 1720565310 | Ramon Omar Rodriguez Hernandez | Physician Assistant | 1500 Route 112 Ste C, Port Jefferson Station, NY 11776-8054 | 2018-07-26 |
| 1689094658 | Gregory Beltrani | Physician Assistant | 38 Hurtin St, Port Jefferson Station, NY 11776-3920 | 2014-04-17 |
| 1386071587 | Thomas J Heinisch | Physician Assistant | 107 Montrose Dr, Port Jefferson Station, NY 11776-1319 | 2013-10-02 |
| 1023378874 | Amanda Marie Wiermann | Physician Assistant | 69 Clymer St, Port Jefferson Station, NY 11776-3753 | 2012-05-25 |
| 1720313414 | Rebecca Allenbrand | Physician Assistant | 815 Hallock Ave Ste A, Port Jefferson Station, NY 11776-1244 | 2009-10-14 |
| 1801031018 | Diane Ranieri | Physician Assistant | Pc 815 Hallock Ave., Suite A Kids First Pediatrics, Port Jefferson Station, NY 11776-1244 | 2008-12-03 |
| 1053364133 | Noami Morey | Physician Assistant | 4724 Nesconset Hwy, Port Jefferson Station, NY 11776-2580 | 2006-05-18 |
| Find all providers in PORT JEFFERSON STATION | ||||
| City | PORT JEFFERSON STATION |
| Zip Code | 11776 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.