Stacey Joy Digiacomo (NPI# 1023233103, PAC ID# 5395067870) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1023233103 |
| PAC ID by PECOS | 5395067870 |
| Professional Enrollment ID | I20160318001864 |
| Full Name | Stacey Joy Digiacomo |
| Organization Legal Name | SQUARE CARE MEDICAL GROUP LLP |
| Address |
191 Herricks Rd Garden City Park NY 11040-5236 |
| Phone Number | 5167422224 |
| Gender | F |
| Graduation Year | 2000 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7012938434 |
| Number of Group Practice Members | 67 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330185 | JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON |
| Address | Phone | Organization |
|---|---|---|
| 191 Herricks Rd, Garden City Park, NY 11040-5236 | 5167422224 | SQUARE CARE MEDICAL GROUP LLP |
| 4 Roosevelt Ave, Port Jefferson Station, NY 11776-3363 | 6313310500 | SQUARE CARE MEDICAL GROUP LLP |
| Organization Legal Name | SQUARE CARE MEDICAL GROUP LLP |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Patricia Paccione | Nurse Practitioner | Square Care Medical Group LLP | 200 W Main St, Suite A103, Babylon, NY 11702-3434 |
| Ella Uvadyeva | Obstetrics/gynecology | Square Care Medical Group LLP | 173 Mineola Blvd, Suite 200, Mineola, NY 11501-2530 |
| Terah J Stiell | Physician Assistant | Square Care Medical Group LLP | 40 Crossways Park Dr, Suite 101, Woodbury, NY 11797-2038 |
| Christopher J Berard | Family Medicine | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Jennifer Slagus | Obstetrics/gynecology | Square Care Medical Group LLP | 48 Route 25a, Suite 207, Smithtown, NY 11787-1448 |
| Charles T Mann | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Laura J Cerlini | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Loren Lyons | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Krista Wasserman | Obstetrics/gynecology | Square Care Medical Group LLP | 1615 Northern Blvd, Suite 106, Manhasset, NY 11030-3033 |
| Ilia E Calluzzo | Obstetrics/gynecology | Square Care Medical Group LLP | 3629 Bell Blvd, Bayside, NY 11361-2056 |
| Street Address |
191 HERRICKS RD |
| City | GARDEN CITY PARK |
| State | NY |
| Zip | 11040-5236 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher J Berard | Family Medicine | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Charles T Mann | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Laura J Cerlini | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Loren Lyons | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Kerry Anp Cummings | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Philip A Schoenfeld | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Jacqueline Pandolfi | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Cecilia Vanisky | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Cindy Tobin | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Lewis Rosenberg | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Usha Kamath | Infectious Disease | 109 Windsor Gate Dr, New Hyde Park, NY 11040-1066 | |
| Karen Baker | Physical Therapy | Prn Physical, Occupational and Speech Therapy Network, Pllc | 99 S Service Rd, North Hills, NY 11040-1076 |
| Kimberly Gore Kaufman | Psychologist, Clinical | Wellqor Psychological Services Northeast, PC | 99 S Service Rd, North Hills, NY 11040-1076 |
| Prakash L Chordia | Psychiatry | 99 S Service Rd, New Hyde Park, NY 11040-1076 | |
| Joyce E Braun | Clinical Social Worker | 187 Robby Ln, Manhasset Hills, NY 11040-1105 | |
| Ronald J Gordon | Psychiatry | 425 Old Courthouse Rd, New Hyde Park, NY 11040-1115 | |
| Carolyn A Garvey Gordon | Clinical Social Worker | 425 Old Courthouse Rd, New Hyde Park, NY 11040-1115 | |
| Irine J Kim | Cardiovascular Disease (cardiology) | 492 Old Courthouse Rd, Manhasset Hills, NY 11040-1142 | |
| Livia G Beck | Psychiatry | 1110 Cedar Dr W, New Hyde Park, NY 11040-1206 | |
| Komal K Kukkar | Physical Therapy | Advance At Home Physical Therapy PC | 39 E St, New Hyde Park, NY 11040-1322 |
| Find all physicians in zip 11040 | |||
| City | GARDEN CITY PARK |
| Zip Code | 11040 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GARDEN CITY PARK + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Stacey Joy Digiacomo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.