Individual provider Active NPI

Emma Patricia Stossel, PA-C

  • Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1083486138
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13717 Issued in NC
Practice address
461 Western Blvd Ste 122
Jacksonville, NC 28546-7637
Phone
(910) 333-0283
Fax
(910) 333-0513
NPI assigned
Oct 23, 2023
Last updated
Oct 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-13717 NC Primary

Addresses

Primary practice location

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637

Mailing address

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637
Phone (910) 333-0283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20231109000165 NC Practitioner - Physician Assistant 2769839927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Star Medical Clinic PLLCGroup PAC ID 6800183963, 10 clinicians

Practice addresses (Care Compare)

461 Western Blvd
Suite 122
Jacksonville, NC 28546-7637
Phone (910) 333-0283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-13717NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Clinic, P.a. 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.

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1083486138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOSSEL",
        "first_name": "EMMA",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.