Stephanie Acevedo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00811300 Issued in NJ

Practice address

201 Route 17 FL 1202
Rutherford, NJ 07070-2557

Phone

(201) 975-2323

Fax

(801) 581-5807

NPI assigned

Apr 28, 2021

Last updated

Oct 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sacevedo103622@direct.optum.com

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.

• Optum Medical Care of New Jersey PC

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  • NPI 1578665048

  NJ

  Medicare reassignment Care Compare group NPD
• Hudson Plastic Surgery NJ LLC

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1942824867

  NJ

  Medicare reassignment
• Optum Medical Care of New Jersey PC

  dba Riverside Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• A.G. Dikengil, MD, PA

  • Radiology Clinic/Center
  • Lyndhurst, NJ
  • NPI 1205992690
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1043892060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ROUTE 17 FL 1202",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702557",
            "telephone_number": "201-975-2323",
            "fax_number": "801-581-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ROUTE 17 FL 1202",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702557",
            "telephone_number": "201-975-2323",
            "fax_number": "801-581-5807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Chipeta Way",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "84108",
            "country_code": "US",
            "telephone_number": "801-581-7766",
            "fax_number": "801-581-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00811300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 4Bienestar LLC
• Aasje
• Apoorva Abbi
• Abraham Haliczer MD LLC
• Adam Krass Consulting, LLC
• Advanced Pain Institute NJ LLC
• Advocare, LLC (Advocare New Jersey Spine and Sports Medicine)
• Ajit M. Shah, MD PC
• Ryan Michael Albern, DC

• Physician Assistant in Rutherford, NJ
• Providers in Rutherford, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.