LACEY E SHAMBO DNP-BC
NPI 1902537038
Nurse Practitioner - Family in Watertown, NY

Q: What is Lacey Shambo's NPI number?

The NPI number for Lacey Shambo is 1902537038. It was assigned to this individual provider in the NPPES registry on June 20, 2022.

Q: What is Lacey Shambo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lacey Shambo was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.

Active since June 20, 2022PECOS EnrolledAccepts Medicare Assignment

18983 US ROUTE 11, WATERTOWN, NY 13601(315) 782-0059 Get Directions Write a Review

NPPES record last updated: March 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 26, 2025, Mar 21, 2025, Jun 20, 2024 and 1 more (4 updates tracked since 2022).

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About Lacey E Shambo Dnp-bc NPPES

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

LACEY E SHAMBO DNP-BC (NPI 1902537038) is an individual family provider in Watertown, New York, licensed in New York (350243) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, is affiliated with Samaritan Medical Center, and maintains 7 additional practice locations.

NPPES Registry Identity

NPI1902537038

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLACEY E SHAMBOCredential: DNP-BC

Location Address18983 US ROUTE 11Watertown, NY 13601-5320

Mailing Address15895 Hamp RdWatertown, NY 13601-6768 · (315) 523-1499

Phone(315) 782-0059

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJune 20, 2022

Last NPPES UpdateMarch 26, 20254 updates tracked since enumeration

NPPES CertifiedMarch 26, 2025

✔ NPI 1902537038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in NY · 350243✔ Licensed in FL · TPAN2536✔ Licensed in TX · 1169690✔ Licensed in DE · LG-0012858✔ Licensed in CO · APN.1000145-NP✔ Licensed in OR · 10042097✔ Licensed in KY · 4036258

Also ListedRegistered NurseTaxonomy 163W00000X · License 689095 (NY)

18983 US ROUTE 11, Watertown, NY 13601

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Secondary Practice Locations 7

Location 13000 N Litchfield Rd Ste 120Goodyear, AZ 85395-7802 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 22025 Memory Ln Ste 300Harker Heights, TX 76548-7488 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 3122 Delaware Street SteF-5New Castle, DE 19720-4814 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 47261 S Broadway Ste 14LLittleton, CO 80122-8019 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 55 Greentree Center, Suite 117Marlton, NJ 08053 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 63499 Blazer Pkwy Ste 325Lexington, KY 40509-2798 · Phone (949) 484-9517 · Fax (949) 569-1295

Location 7635 Main St Ste 206AKlamath Falls, OR 97601-6007 · Phone (949) 484-9517 · Fax (949) 569-1295

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

Lacey E Shambo Dnp-bc 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 ID9335516392

PECOS Enrollment IDI20221103001130

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 5

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

142 services76 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

123 services79 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

12 services12 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

11 services11 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Samaritan Medical Center

Acute Care Hospitals · Watertown, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330157

Location830 Washington StreetWatertown, NY 13601 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13601 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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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Other Providers at the Same Location NPPES 4

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

SHELBY MARGARET SCORDO PA

Physician Assistant

18983 US ROUTE 11
WATERTOWN, NY 13601

Jefferson County (315) 782-0059

DR. CHRISTOPHER PHILIP BLACK M.D.

Family Medicine

18983 US ROUTE 11
WATERTOWN, NY 13601

Jefferson County (315) 782-0059

KAREN ANNE WILLIAMS MD

Family Medicine

18983 US ROUTE 11
WATERTOWN, NY 13601

Jefferson County (315) 782-0059

KAREN A. WILLIAMS, MD, PC

Family Medicine

18983 US ROUTE 11
WATERTOWN, NY 13601

Jefferson County (315) 782-0059

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 Lacey Shambo's NPI number?

The NPI number for Lacey Shambo is 1902537038. It was assigned to this individual provider in the NPPES registry on June 20, 2022.

Where is Lacey Shambo located?

Lacey Shambo practices at 18983 Us Route 11, Watertown, NY 13601. The listed phone number is (315) 782-0059.

What is Lacey Shambo's specialty?

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

Is Lacey Shambo enrolled in Medicare?

Yes. Lacey Shambo 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.

Is Lacey Shambo affiliated with any hospitals?

According to CMS data, Lacey Shambo is affiliated with Samaritan Medical Center.

When was this NPI record last updated?

The NPPES record for Lacey Shambo was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.