Active NPI
Tara Michelle Stepp, PA-C
- Physician Assistant
- Cape Coral, FL
National Provider Identifier
1043457310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9107566
- Practice address
- 1682 NE Pine Island Rd
Cape Coral, FL 33909-1756 - Phone
- (239) 424-1655
- Fax
- (239) 424-1649
- NPI assigned
- Jan 8, 2009
- Last updated
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9107566 | FL | Primary |
Addresses
Primary practice location
1682 NE Pine Island Rd
Cape Coral, FL 33909-1756
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1400
Other names 1
- Tara Michelle Portillo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9107566 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leeland ER SVCS Partnership LLC | Past | Accepting new patients | |
| Emcare Physician Providers, Inc. | Past | Accepting new patients | |
| Emcare Physician Providers, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1043457310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-424-1400",
"fax_number": "239-424-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1682 NE PINE ISLAND RD",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339091756",
"telephone_number": "239-424-1655",
"fax_number": "239-424-1649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPP",
"first_name": "TARA",
"middle_name": "MICHELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-08",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9107566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TARA",
"last_name": "PORTILLO",
"middle_name": "MICHELLE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.