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

Individual provider Physician Assistant · NPI 1023233103

Stacey Digiacomo, PA is a Physician Assistant in Port Jefferson Station, New York. Qualified in 2000, 26 years ago. Practices with Square Care Medical Group LLP, a 72-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
26
Licensed in
NY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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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

Physician Assistant (primary) Taxonomy 363A00000X · Licence 007238 (NY)

Record details

NPI number1023233103
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
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 specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Square Care Medical Group Llp — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Port Jefferson Station