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

Stacey Mae Perrotta, NP

Individual provider Child & Adolescent Psychiatry Physician · NPI 1174258966

Stacey Mae Perrotta, NP is a Nurse Practitioner in Rochester, New York. Qualified in 2022, 4 years ago. Practices with Gavia Lifecare Center, LLC, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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

1081 Long Pond Rd Ste 100
Rochester, NY 14626-5002
Phone: (585) 371-6464
Fax: (585) 371-6464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F404153-01 (NY)
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X · Licence 404153 (NY)

Record details

NPI number1174258966
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 18, 2022
Last updated in NPPESMarch 25, 2024
Certification dateMarch 25, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Gavia Lifecare Center, Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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