STACEY GOMBETTO RPA-C NPI 1427094895

NPI Information

NPI: 1427094895
Provider Name: STACEY GOMBETTO, RPA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
1425 PORTLAND AVE
TWIG MEDICAL GROUP
ROCHESTER, NY
ZIP 14621
Phone: (585) 922-2197
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Stacey Gombetto, RPA-C is a medical physician assistant in Rochester, NY. Stacey Gombetto, RPA-C NPI is 1427094895. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1425 PORTLAND AVE
TWIG MEDICAL GROUP
ROCHESTER, NY
ZIP 14621-001
Phone: (585) 922-2197

The enumeration date for this NPI number is 6/22/2006 and was last updated on 10/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	004655	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	02512545	MEDICAID	NEW YORK
2	J400021099	MEDICARE PIN	NEW YORK
3	S09183	MEDICARE UPIN
4	P71019-GRP:70008A	MEDICARE PIN	NEW YORK
5	PA0040-GRP:BA0017	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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