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

Cecilia Vanisky, NP

Individual provider Nurse Practitioner · NPI 1225253222

Cecilia Vanisky, NP is a Nurse Practitioner in Port Jefferson Station, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 1989, 37 years ago. Practices with Square Care Medical Group LLP, a 72-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
37
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2007
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4 Roosevelt Ave
Port Jefferson Station, NY 11776-3363
Phone: (631) 331-0500
Fax: (631) 331-1644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Nurse Practitioner (primary) Taxonomy 363LX0001X · Licence 360059 (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence 360059 (NY)

Record details

NPI number1225253222
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 16, 2007
Last updated in NPPESDecember 3, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 1989 (37 years in practice)
Group practice Square Care Medical Group Llp — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Port Jefferson Station