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DR. BRIAN KHRISTOPHER STACKHOUSE MD
NPI 1871234989
Student in an Organized Health Care Education/Training Program in Staten Island, NY

Active since April 05, 2022PECOS Enrolled
376 SEGUINE AVE, STATEN ISLAND, NY 10309(718) 226-5976(718) 226-2789 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Brian Khristopher Stackhouse Md NPPES

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

DR. BRIAN KHRISTOPHER STACKHOUSE MD (NPI 1871234989) is an individual student in an organized health care education/training program in Staten Island, New York and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1871234989
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. BRIAN KHRISTOPHER STACKHOUSECredential: MD
Location Address376 SEGUINE AVEStaten Island, NY 10309-3942
Mailing Address376 Seguine AveStaten Island, NY 10309-3942 · (718) 226-5976 · Fax (718) 226-2789
Phone(718) 226-5976
Fax(718) 226-2789
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 5, 2022
NPPES CertifiedApril 4, 2022
✔ NPI 1871234989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
376 SEGUINE AVE, Staten Island, NY 10309
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Brian Khristopher Stackhouse Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103383054
PECOS Enrollment IDI20260811001006
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.

Medicare Billing Reassignment

Medicare enrollment records show Brian Stackhouse reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Medical PC
30 mi
Internal Medicine
270-05 76TH AVE
New Hyde Park, NY 11040
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1790043479 (516) 465-8089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ISHAK NOBEL MD
Student in an Organized Health Care Education/Training Program
376 SEGUINE AVE
STATEN ISLAND, NY 10309
Richmond County (718) 226-5976
ROBERT GABRIEL STERN MD
Psychiatry & Neurology (Psychiatry)
376 SEGUINE AVE, STATEN ISLAND UNIVERSITY HOSPITAL
STATEN ISLAND, NY 10309
Richmond County (718) 226-2351
LORAINE HARVEY MD
Student in an Organized Health Care Education/Training Program
376 SEGUINE AVE
STATEN ISLAND, NY 10309
Richmond County (718) 226-5976

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 Brian Stackhouse's NPI number?

The NPI number for Brian Stackhouse is 1871234989. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Where is Brian Stackhouse located?

Brian Stackhouse practices at 376 Seguine Ave, Staten Island, NY 10309. The listed phone number is (718) 226-5976.

What is Brian Stackhouse's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Brian Stackhouse enrolled in Medicare?

Yes. Brian Stackhouse is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brian Stackhouse's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Stackhouse reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The 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 Brian Stackhouse'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 Brian Stackhouse was last updated on April 5, 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.