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DR. STEPHEN JAMES PETRUCCELLI D.C.
NPI 1710045208
Chiropractor - Sports Physician in Sag Harbor, NY

Active since December 05, 2006
39 DIVISION STREET, SAG HARBOR, NY 11963(631) 725-8209(631) 919-1592 Get Directions Write a Review

NPPES record last updated: March 17, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Stephen James Petruccelli D.c. NPPES

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

DR. STEPHEN JAMES PETRUCCELLI D.C. (NPI 1710045208) is an individual sports physician in Sag Harbor, New York, licensed in New York (X010203) and active in the NPI registry since December 2006. He is affiliated with Suny/stony Brook University Hospital and is a graduate of Other (2001).

NPPES Registry Identity

NPI1710045208
Entity TypeIndividualMale
Primary Taxonomy111NS0005X
Provider Legal NameDR. STEPHEN JAMES PETRUCCELLICredential: D.C.
Location Address39 DIVISION STREETSag Harbor, NY 11963
Mailing AddressPo Box 2902Sag Harbor, NY 11963-0401 · (631) 725-8209 · Fax (631) 725-8209
Phone(631) 725-8209
Fax(631) 919-1592
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateDecember 5, 2006
Last NPPES UpdateMarch 17, 2011
✔ NPI 1710045208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in NY · X010203
Definition
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
39 DIVISION STREET, Sag Harbor, NY 11963
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Other Identifiers 2

Medicare ID-Type UnspecifiedX4N041NY · Medicare Provide Id
Medicare UPINU87714NY

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. Stephen James Petruccelli D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577534536
PECOS Enrollment IDI20040803001316

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
389 services72 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

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 Stephen Petruccelli's NPI number?

The NPI number for Stephen Petruccelli is 1710045208. It was assigned to this individual provider in the NPPES registry on December 5, 2006.

Where is Stephen Petruccelli located?

Stephen Petruccelli practices at 39 Division Street, Sag Harbor, NY 11963. The listed phone number is (631) 725-8209.

What is Stephen Petruccelli's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Stephen Petruccelli enrolled in Medicare?

Yes. Stephen Petruccelli is registered in the Medicare PECOS enrollment system.

Is Stephen Petruccelli affiliated with any hospitals?

According to CMS data, Stephen Petruccelli is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Stephen Petruccelli was last updated on March 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.