Stacy Zachman Dobreff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001293 Issued in IL

Practice address

3537 W Front St Ste E
Traverse City, MI 49684-7943

Phone

(231) 935-8930

NPI assigned

Jun 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bronson South Haven Hospital

  dba Bronson Medical Group

  • Family Medicine Physician
  • South Haven, MI
  • NPI 1174749170
  Medicare reassignment NPD
• Bronson South Haven Hospital

  • General Acute Care Hospital
  • South Haven, MI
  • NPI 1346275856
  NPD
• West Front Primary Care, P.L.L.C.

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1356260814
  NPD (past)

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1033346069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST STE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847943",
            "telephone_number": "231-935-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST STE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847943",
            "telephone_number": "231-935-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBREFF",
        "first_name": "STACY",
        "middle_name": "ZACHMAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033346069",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Discover Health Chiropractic Center PC
• Lija Vija Ditmar, MSW
• Cynthia Diver, PT
• Angela Kay Dixon, LMSW
• Rebecca R. Dobler, LMSW
• Shannon Dodds, LMSW
• Thomas R Doerr, M.D.
• Christopher Doherty
• Tara Rene Dohm, DMD
• Elizabeth Ann Dole, FAACVPR

• Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.