DR. STACEY BOLEY SANDUSKY PHD
NPI 1700135258
Psychologist - Clinical in Tampa, FL

Q: What is Stacey Sandusky's NPI number?

The NPI number for Stacey Sandusky is 1700135258. It was assigned to this individual provider in the NPPES registry on August 30, 2012.

Q: What is Stacey Sandusky'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 Stacey Sandusky was last updated on August 30, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 30, 2012PECOS Enrolled

13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612(813) 972-2000(813) 631-3188 Get Directions Write a Review

NPPES record last updated: August 30, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Stacey Boley Sandusky Phd NPPES

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

DR. STACEY BOLEY SANDUSKY PHD (NPI 1700135258) is an individual clinical provider in Tampa, Florida, licensed in Florida (PY 8569) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700135258

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. STACEY BOLEY SANDUSKYCredential: PHD

Location Address13000 BRUCE B DOWNS BLVDTampa, FL 33612-4745

Mailing Address13000 Bruce B Downs BlvdTampa, FL 33612-4745 · (813) 972-2000 · Fax (813) 631-3188

Phone(813) 972-2000

Fax(813) 631-3188

Sole ProprietorNo

Enumeration DateAugust 30, 2012

✔ NPI 1700135258 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 FL · PY 8569

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.

13000 BRUCE B DOWNS BLVD, Tampa, FL 33612

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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 (PECOS)

Dr. Stacey Boley Sandusky Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 33612 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

$171.84 typical visit price

range $56.00 – $171.84

Typical copayment $42.96 (range $14.00 – $42.96)

Most-billed visit code 99205

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

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