Stephanie Duverge

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

309667 Issued in NY

Practice address

53 Union St Apt 1
Randolph, MA 02368-4926

Phone

(781) 510-0858

NPI assigned

Jan 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Nurse Practitioner

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.

• Siuc Medical PC

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1467826594
  Medicare reassignment NPD
• 1211 WPR Medical Services PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1437247509
  NPD

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1053819326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 UNION ST APT 1",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 UNION ST APT 1",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684926",
            "telephone_number": "781-510-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVERGE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2313980",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2313980",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "309667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline S Dunn
• Debra Dunn
• Katherine Dunn
• Lory S Duplessis
• Paula Marie Duvelson-Chrysostome, PH.D., LMHC
• Matthew Bennett Easley
• Lauren Eaton, M.A, BCBA
• Ann Akuba Eche
• Ifeoma Mary Eche, PHARM. D., BCPS
• Rachelle C Eddins

• Dermatology Physician in Randolph, MA
• Providers in Randolph, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.