Individual provider Active NPI

Alyssa Marie Stephany, M.D.

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1033376405
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2020037500 Issued in MO
Practice address
4301 NE Parvin Rd
Kansas City, MO 64117-3001
Phone
(315) 247-1123
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-43877 KS
Internal Medicine Physician 207R00000X 2008-00772 NC
Internal Medicine Physician 207R00000X 65003 WI
Pediatrics Physician 208000000X 04-43877 KS
Pediatrics Physician 208000000X 2020037500 MO
Pediatrics Physician 208000000X 2008-00772 NC
Pediatrics Physician 208000000X 65003 WI
Hospitalist Physician 208M00000X 2020037500 MO
Hospitalist Physician 208M00000X 04-43877 KS
Internal Medicine Physician 207R00000X 2020037500 MO Primary

Addresses

Primary practice location

4301 NE Parvin Rd
Kansas City, MO 64117-3001

Mailing address

4301 NE Parvin Rd
Kansas City, MO 64117-3001

Other identifiers 2

IdentifierTypeStateIssuer
1033376405MedicaidKS
1033376405MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160127000659 WI Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 8820151277 Reassigns benefits to 2 organizations
I20241016001620 MO Practitioner - Internal Medicine 8820151277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
65003WIMDRegistered Nurse
04-43877KSMDInternal Medicine Physician
2008-00772NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Tiffany Springs Rehabilitation & Health Care Center LLC Past Accepting new patients
Theoria Medical Internal Medicine Past Accepting new patients
Highland Nursing and Rehabilitation Center, LLC Past Accepting new patients
Northland Rehabilitation & Health Care Center LLC Past Accepting new patients

Locations

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1033376405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NE PARVIN RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641173001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NE PARVIN RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641173001",
            "telephone_number": "315-247-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHANY",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-43877",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008-00772",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "65003",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-43877",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2020037500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-00772",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "65003",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2020037500",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "04-43877",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020037500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033376405",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033376405",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.