MRS. STACEY C AZZOLINO (PA) – Physician Assistant, NPI 1770796625
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for MRS. STACEY C AZZOLINO (PA)
12190 CORTEZ BLVD
BROOKSVILLE, FL 346135578
Phone: (352) 597-1206
Fax: (352) 597-1208
Type: Mailing
Valley Health Plaza, Paramus, Bergen County, New Jersey, 07652, United States
PARAMUS, NJ 076523628
Phone: (201) 634-5547
Fax: (201) 634-5381
Type: Mailing
PO BOX 419457
BOSTON, MA 022416457
Phone: (844) 362-1735
Fax: (973) 290-7495
Type: Mailing
12902 USF MAGNOLIA DR
TAMPA, FL 336129416
Phone: (813) 745-4673
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 55 Open Payments records for all available years, with a total value of $2,595.
Total Amount is formed as General ($2,595) + Research ($0) + Ownership ($0) = $2,595.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($1,536).
Total Amount
$2,595
General + Research + Ownership
Payments
55
Total payment records
General Amount
$2,595
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $1,536 |
| Medtronic, Inc. | $363 |
| Mirati Therapeutics, Inc. | $137 |
| Novartis Pharmaceuticals Corporation | $129 |
| Janssen Biotech, Inc. | $125 |
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: 2022-08-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220809002110 | I | Physician Assistant | FL | TBD |
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.
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 34613)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Cardiac Surgery, Thoracic Surgery, Vascular Surgery | FL | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL | |
| Cardiovascular Disease (Cardiology) | FL | |
| Thoracic Surgery, General Surgery | MD | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL |
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