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STACY SANICOLA NURSE PRACTITIONER
NPI 1790200459
Nurse Practitioner - Family in Staten Island, NY

Active since August 03, 2017PECOS EnrolledAccepts Medicare Assignment
477 PHILIP AVE, STATEN ISLAND, NY 10312(917) 295-3957 Get Directions Write a Review

NPPES record last updated: April 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 11, 2023, Aug 3, 2017 (2 updates tracked since 2017).

About Stacy Sanicola Nurse Practitioner NPPES

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

STACY SANICOLA NURSE PRACTITIONER (NPI 1790200459) is an individual family provider in Staten Island, New York, licensed in New York (342171) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1790200459
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSTACY SANICOLACredential: NURSE PRACTITIONER
Location Address477 PHILIP AVEStaten Island, NY 10312-5818
Mailing Address73 Gervil StStaten Island, NY 10309-4230 · (917) 295-3957
Phone(917) 295-3957
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateAugust 3, 2017
Last NPPES UpdateApril 11, 20232 updates tracked since enumeration
NPPES CertifiedApril 11, 2023
✔ NPI 1790200459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 342171
477 PHILIP AVE, Staten Island, NY 10312
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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 Sanicola Nurse Practitioner 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 ID2668816448
PECOS Enrollment IDI20240220003284
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.

Areas of Expertise CMS Part B claims 2

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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
17 services17 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10312 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Sanicola's NPI number?

The NPI number for Stacy Sanicola is 1790200459. It was assigned to this individual provider in the NPPES registry on August 3, 2017.

Where is Stacy Sanicola located?

Stacy Sanicola practices at 477 Philip Ave, Staten Island, NY 10312. The listed phone number is (917) 295-3957.

What is Stacy Sanicola's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Stacy Sanicola enrolled in Medicare?

Yes. Stacy Sanicola 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 Sanicola was last updated on April 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.