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

Stacy Koch, RN, CCRN

Individual provider Certified Registered Nurse Anesthetist · NPI 1104291798

Stacy Koch, RN, CCRN is a Certified Registered Nurse Anesthetist (CRNA) in Clarence, New York. Qualified in 2018, 8 years ago. Practices with Parkside Medical Anesthesia Associates, a 30-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2015
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Practice location Address checks out

9665 Rocky Pt
Clarence, NY 14031-1588
Phone: (716) 759-7717
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 118382 (NY)

Record details

NPI number1104291798
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN , CCRN
Sole proprietorNo
NPI enumeratedDecember 8, 2015
Last updated in NPPESMay 23, 2019
Mailing address9665 Rocky Pt, Clarence, NY 14031-1588

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Parkside Medical Anesthesia Associates — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare