Individual provider Active NPI

Stephanie Arria Nekoroski

  • Women's Health Nurse Practitioner
  • San Rafael, CA
National Provider Identifier
1073290433
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95024482 Issued in CA
Practice address
2 H St
San Rafael, CA 94901-1700
Phone
(415) 459-4907
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 95024482 CA Primary

Addresses

Primary practice location

2 H St
San Rafael, CA 94901-1700

Mailing address

325 Octavia St Apt 528
San Francisco, CA 94102-5891
Phone (978) 806-6970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230913002974 CA Order and Referring Only - Nurse Practitioner 7810351582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95024482CAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1073290433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 OCTAVIA ST APT 528",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025891",
            "telephone_number": "978-806-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 H ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011700",
            "telephone_number": "415-459-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEKOROSKI",
        "first_name": "STEPHANIE",
        "middle_name": "ARRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95024482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.