STACY SANICOLA NURSE PRACTITIONER
NPI 1790200459
Nurse Practitioner - Family in Staten Island, NY
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Stacy Sanicola reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10065
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Weill Cornell Imaging At New York Presbyterian
- 252 clinicians in this Medicare group
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 249 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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.
Which organizations bill Medicare for Stacy Sanicola's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Sanicola reassigns Medicare benefits to 2 organizations: Weill Cornell Medical Imaging (New York, NY) and Weill Medical College Of Cornell (New York, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacy Sanicola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Stacy Sanicola, NURSE PRACTITIONER · NPI 1790200459
Family physician in Staten Island, New York. Individual provider, active in the CMS NPPES registry since August 3, 2017.
## Identity
- **NPI:** 1790200459 (Entity type: Individual)
- **Enumerated:** August 3, 2017
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 342171 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 477 PHILIP AVE, Staten Island, NY 10312-5818
- **Phone:** (917) 295-3957
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Weill Cornell Medical Imaging (NPI 1417134792, New York, NY); Weill Medical College Of Cornell (NPI 1538109269, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** April 11, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1790200459) · Data from the CMS NPPES public registry.