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

MS. Stacy Ann Johnson, RN

Individual provider Adult Health Nurse Practitioner · NPI 1083967616

MS. Stacy Ann Johnson, RN is a Nurse Practitioner in Rochester, New York. Qualified in 2019, 7 years ago. Practices with Rochester General Hospital, a 1,197-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2012
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

1415 Portland Ave Ste 200
Rochester, NY 14621-3022
Phone: (585) 922-0390
Fax: (585) 922-0395
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 300 Crosman Ter, Rochester, NY 14620-1822 — (585) 773-1849
  • 105 Canal Landing Blvd Ste 1, Rochester, NY 14626-5107 — (585) 368-4050

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 309651 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 577104 (NY)

Record details

NPI number1083967616
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedOctober 19, 2012
Last updated in NPPESFebruary 1, 2023
Certification dateFebruary 1, 2023
Mailing address100 Kings Hwy S, Rochester, NY 14617-5504

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Rochester General Hospital — 1197 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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