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AMY LORRAINE STACY MS, RD, CDN
NPI 1053539023
Dietitian, Registered in Brockport, NY

Active since April 23, 2007Accepts Medicare Assignment
95.19/100
CMS Quality Rating
156 WEST AVE, BROCKPORT, NY 14420(585) 395-6095 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amy Lorraine Stacy Ms, Rd, Cdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY LORRAINE STACY MS, RD, CDN (NPI 1053539023) is an individual dietitian, registered in Brockport, New York, licensed in New York (000777-1) and active in the NPI registry since April 2007. She is a graduate of Other (1989).

NPPES Registry Identity

NPI1053539023
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameAMY LORRAINE STACYCredential: MS, RD, CDN
Location Address156 WEST AVEBrockport, NY 14420-1229
Mailing Address7434 Maple AveBergen, NY 14416-9404 · (585) 494-1505
Phone(585) 395-6095
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateApril 23, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1053539023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in NY · 000777-1
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
156 WEST AVE, Brockport, NY 14420
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amy Lorraine Stacy Ms, Rd, Cdn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729128707
PECOS Enrollment IDI20091223000256

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14420 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality70.62
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKESIDE IMAGING, LLC
Radiology (Diagnostic Radiology)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (716) 859-2954
DR. TIMOTHY VERNON HAGY M.D.
Emergency Medicine (Emergency Medical Services)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 395-6095
UNIVERSITY OF ROCHESTER
Pharmacy (Community/Retail Pharmacy)
156 WEST AVE, PHARMACY
BROCKPORT, NY 14420
Monroe County (585) 758-7562
ERIK PETERSON D.O.
Emergency Medicine
156 WEST AVE, EMERGENCY DEPARTMENT
BROCKPORT, NY 14420
Monroe County (585) 395-6095
EMMA LEATHAM PA-C
Physician Assistant (Medical)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 758-7557
INTERNAL MEDICINE AT LAKESIDE
Internal Medicine
156 WEST AVE, SUITE 106
BROCKPORT, NY 14420
Monroe County (585) 395-6095
JORDAN BLOCK
Physical Therapist (Orthopedic)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 275-5321
ISABELLE JOY KARPOVICH
Physical Therapist (Orthopedic)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 341-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Stacy's NPI number?

The NPI number for Amy Stacy is 1053539023. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Amy Stacy located?

Amy Stacy practices at 156 West Ave, Brockport, NY 14420. The listed phone number is (585) 395-6095.

What is Amy Stacy's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Amy Stacy enrolled in Medicare?

Yes. Amy Stacy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Amy Stacy was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.