Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Austin Stacy

Individual provider Physician Assistant · NPI 1174238315

Austin Stacy is a Physician Assistant in Edgewood, Kentucky. Qualified in 2020, 6 years ago. Practices with Summit Medical Group Inc, a 799-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana and Kentucky.

Years since qualifying
6
Licensed in
IN, KY
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone: (859) 344-1600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 368 Bielby Road, Lawrenceburg, IN 47025-1099 — (812) 496-8771
  • 650 Sprucewood Ln, Erlanger, KY 41018-1062 — (859) 282-6600

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA3206 (KY)
Physician Assistant Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 10004430A (IN)

Record details

NPI number1174238315
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 23, 2023
Last updated in NPPESJuly 2, 2024
Certification dateJuly 2, 2024
Mailing address650 Sprucewood Ln, Erlanger, KY 41018-1062

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Edgewood