STACY ELLENBERG PHD
NPI 1285372870
Psychologist - Clinical in Ithaca, NY

Q: What is Stacy Ellenberg's NPI number?

The NPI number for Stacy Ellenberg is 1285372870. It was assigned to this individual provider in the NPPES registry on May 24, 2022.

Q: What is Stacy Ellenberg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Ellenberg was last updated on May 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 24, 2022PECOS EnrolledAccepts Medicare Assignment

86.47/100

CMS Quality Rating

6 YARDLEY GRN, ITHACA, NY 14850(508) 245-2276 Get Directions Write a Review

NPPES record last updated: May 24, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stacy Ellenberg Phd NPPES

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

STACY ELLENBERG PHD (NPI 1285372870) is an individual clinical provider in Ithaca, New York, licensed in New York (112047-01) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1285372870

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameSTACY ELLENBERGCredential: PHD

Location Address6 YARDLEY GRNIthaca, NY 14850-1259

Mailing Address6 Yardley GrnIthaca, NY 14850-1259 · (508) 245-2276

Phone(508) 245-2276

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 24, 2022

NPPES CertifiedMay 24, 2022

✔ NPI 1285372870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 112047-01

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

6 YARDLEY GRN, Ithaca, NY 14850

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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

Stacy Ellenberg Phd 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 ID6800263187

PECOS Enrollment IDI20221028001216

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14850 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

$166.88 typical visit price

range $54.87 – $166.88

Typical copayment $41.72 (range $13.71 – $41.72)

Most-billed visit code 99205

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.

86.47/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.85

Promoting Interoperability

100

Improvement Activities

Cost

50.56

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 Stacy Ellenberg's NPI number?

The NPI number for Stacy Ellenberg is 1285372870. It was assigned to this individual provider in the NPPES registry on May 24, 2022.

Where is Stacy Ellenberg located?

Stacy Ellenberg practices at 6 Yardley Grn, Ithaca, NY 14850. The listed phone number is (508) 245-2276.

What is Stacy Ellenberg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Stacy Ellenberg enrolled in Medicare?

Yes. Stacy Ellenberg 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 Stacy Ellenberg was last updated on May 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.