Stacy Ellenberg, PHD in Ithaca, NY - Medicare Psychologist Provider

Stacy Ellenberg, PHD is a medicare enrolled "Psychologist - Clinical" provider in Ithaca, New York. Her current practice location is 6 Yardley Grn, Ithaca, New York. You can reach out to her office (for appointments etc.) via phone at (508) 245-2276.

Stacy Ellenberg is licensed to practice in New York (license number 112047-01) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1285372870.

Contact Information

	Stacy Ellenberg, PHD
	6 Yardley Grn, Ithaca, NY 14850-1259
	(508) 245-2276
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Stacy Ellenberg
Gender	Female
Speciality	Psychologist - Clinical
Location	6 Yardley Grn, Ithaca, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285372870
Provider Enumeration Date: 05/24/2022
Last Update Date: 05/24/2022

Medicare PECOS Information:

PECOS PAC ID: 6800263187
Enrollment ID: I20221028001216

Medical Identifiers

Medical identifiers for Stacy Ellenberg such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285372870	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	112047-01 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stacy Ellenberg allows following entities to bill medicare on her behalf.

Entity Name	Suny Health Science Center At Syracuse
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184974529 PECOS PAC ID: 7214833086 Enrollment ID: O20031211000420

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Ellenberg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Stacy Ellenberg, PHD 6 Yardley Grn, Ithaca, NY 14850-1259 Ph: (508) 245-2276	Stacy Ellenberg, PHD 6 Yardley Grn, Ithaca, NY 14850-1259 Ph: (508) 245-2276

Reviews and Comments

Psychologist in Ithaca, NY

Randy E Patterson, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 110 Ho Plz, Ithaca, NY 14853 Phone: 607-255-5155
Dr. David Shaw Frahm, PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 903 Hanshaw Rd, Suite 7, Ithaca, NY 14850 Phone: 607-333-7337 Fax: 607-333-7337
Kenneth Miles Cohen, Psychologist Medicare: Not Enrolled in Medicare Practice Location: Cornell University Health Services, Ho Plaza, Ithaca, NY 14853 Phone: 607-255-6946 Fax: 607-254-3503
Dr. Leslie Davis Byron, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1001 W Seneca St Ste 100, Ithaca, NY 14850 Phone: 607-277-8020 Fax: 607-277-7961
Dr. Alexandra Lerner, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10 Whitetail Dr, Ithaca, NY 14850 Phone: 518-545-1030
Sarah M Markowitz, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 950 Danby Rd Ste 202, Ithaca, NY 14850 Phone: 607-260-3100
Sharon Ryan Mier, Psychologist Medicare: Not Enrolled in Medicare Practice Location: Cornell University Health Services, Ho Plaza, Ithaca, NY 14853 Phone: 607-255-6946 Fax: 607-254-3503

Stacy Ellenberg, PHD - Medicare Psychologist in Ithaca, NY