Individual provider Active NPI

Stephanie Abdea Hodgson, RN, MS, ACNP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1003338500
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431148 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(646) 754-7451
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431148 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

Other names 1

  • Stephanie Abdea Sublaban Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180518002267 CA Practitioner - Nurse Practitioner 4082979182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
431148NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Apr 25, 2018 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Apr 25, 2018 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1003338500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "646-754-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "STEPHANIE",
        "middle_name": "ABDEA",
        "credential": "RN, MS, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SUBLABAN",
            "middle_name": "ABDEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.