Stacey Ann Gennis, PNP
Nurse Practitioner, Pediatrics in Boston, MA. Individual provider (NPI-1).
NPI number1033879986
StatusActive
Last updated in NPPESDec 20, 2021
Details
- NPI
- 1033879986
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Stacey Ann Gennis
- Credential
- PNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 20, 2021
- Certification date
- Dec 20, 2021
- Last updated
- Dec 20, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | RN216459 | MA | Yes |
Practice location
300 Longwood AveBoston, MA 02115-5724
Phone 617-355-6000
Mailing address
300 Longwood AveBoston, MA 02115-5724
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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