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

Stacy Sanicola, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1790200459

Stacy Sanicola, NURSEPRACTITIONER is a Nurse Practitioner in Staten Island, New York. Qualified in 2012, 14 years ago. Practices with Weill Cornell Imaging at New York Presbyterian, a 147-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2017
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Practice location Address checks out

477 Philip Ave
Staten Island, NY 10312-5818
Phone: (917) 295-3957
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 342171 (NY)

Record details

NPI number1790200459
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedAugust 3, 2017
Last updated in NPPESApril 11, 2023
Certification dateApril 11, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Weill Cornell Imaging At New York Presbyterian — 147 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Staten Island