LACEY E SHAMBO DNP-BC
NPI 1902537038
Nurse Practitioner - Family in Watertown, NY
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
Specialties & Licenses 2
Secondary Practice Locations 7
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
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.
Medicare Billing Reassignments
3Medicare enrollment records show Lacey Shambo reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Watertown, NY 13601
- Reassigned Medicare billing, New York enrollment
- 4 clinicians in this Medicare group
Pittsford, NY 14534
- Reassigned Medicare billing, New York enrollment
- 108 clinicians in this Medicare group
Columbus, OH 43215
- Reassigned Medicare billing, Colorado and Texas enrollments
- 8 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 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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Samaritan Medical Center
Acute Care Hospitals · Watertown, NYRiver Hospital Clinics
Critical Access Hospitals · Alexandria Bay, NYCarthage Area Hospital, Inc
Critical Access Hospitals · Carthage, NYPhysician 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.
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.
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.
Which organizations bill Medicare for Lacey Shambo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lacey Shambo reassigns Medicare benefits to 3 organizations: Karen A. Williams, MD, PC (Watertown, NY), Midtown East Medical Services, PC (Pittsford, NY) and Jonathan Larson MD PC (Columbus, OH). 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 Lacey Shambo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Lacey Shambo affiliated with any hospitals?
According to CMS data, Lacey Shambo is affiliated with Samaritan Medical Center, River Hospital Clinics and Carthage Area Hospital, Inc.
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 19 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.
# Lacey E Shambo, DNP-BC · NPI 1902537038
Family physician in Watertown, New York. Individual provider, active in the CMS NPPES registry since June 20, 2022.
## Identity
- **NPI:** 1902537038 (Entity type: Individual)
- **Enumerated:** June 20, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 350243 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 18983 US ROUTE 11, Watertown, NY 13601-5320
- **Phone:** (315) 782-0059
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): Karen A. Williams, MD, PC (NPI 1992898191, Watertown, NY); Midtown East Medical Services, PC (NPI 1801292800, Pittsford, NY); Jonathan Larson MD PC (NPI 1487334843, Columbus, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** March 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1902537038) · Data from the CMS NPPES public registry.