STACY ELLEN CRUESS (PHD) – Clinical Psychologist, NPI 1063511681

STACY ELLEN CRUESS (PHD) is a healthcare provider. based in Norwich, Connecticut. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 002704 (CT). The NPI Number for STACY ELLEN CRUESS (PHD) is 1063511681

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
STACY ELLEN CRUESS (PHD)
NPI
1063511681
Phone
(860) 425-8740
Address
164 OTROBANDO AVE
Enumeration Date
21 September 2006
Last Update Date
25 April 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Secondary Phone
8608860012
Graduation Year
1999 (27 years ago)
PAC ID
6709055767
Group Practice PAC ID
3173866241
Professional Enrollment ID
I20110808000601
Address ID
CT063602116NO164XXAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

586 CLINICAL PSYCHOLOGIST in CT

Provider Addresses for STACY ELLEN CRUESS (PHD)

  • 164 OTROBANDO AVE

    NORWICH, CT 063602116

    Phone: (860) 425-8740

    Type: Mailing

  • Medical Office Building, 85, Seymour Street, Frog Hollow Historic District, Hartford, Hartford County, Connecticut, 06106, United States

    HARTFORD HOSPITAL NEUROLOGY DEPT

    HARTFORD, CT 061065501

    Phone: (860) 972-3621

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110808000601IClinical PsychologistCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06360)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173866241View full group profile
NameSpecialtyState
-CT
Nurse PractitionerCT
Nurse PractitionerCT
-CT
-CT
-CT
Internal MedicineCT
Internal MedicineCT
Nurse PractitionerCT
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)CT

Reviews

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Frequently asked questions

Where can patients find STACY ELLEN CRUESS (PHD)'s NPI?
You can confirm STACY ELLEN CRUESS (PHD) with NPI 1063511681; it appears in the national provider directory.
Is STACY ELLEN CRUESS (PHD) active in the national directory?
STACY ELLEN CRUESS (PHD)'s public NPI profile is in an active state.
What does STACY ELLEN CRUESS (PHD) treat or focus on?
Patients typically see STACY ELLEN CRUESS (PHD) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does STACY ELLEN CRUESS (PHD) practice in Connecticut?
You will see Norwich, Connecticut on file for STACY ELLEN CRUESS (PHD) alongside any extra practice locations.
How can I contact STACY ELLEN CRUESS (PHD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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