Individual provider Active NPI

Stacy Lynn Pasquarella, MPA-C

  • Physician Assistant
  • Sebring, FL
National Provider Identifier
1083767537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9104031 Issued in FL
Practice address
2373 US Highway 27 S
Sebring, FL 33870-4926
Phone
(863) 763-5675
Fax
(863) 382-2561
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA 9104031 FL Primary

Addresses

Primary practice location

2373 US Highway 27 S
Sebring, FL 33870-4926

Mailing address

2373 US Highway 27 S
Sebring, FL 33870-4926
Phone (863) 763-5675

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA 9104031FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: stacy.pasquarella.1@19457.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083767537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338704926",
            "telephone_number": "863-763-5675",
            "fax_number": "863-382-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338704926",
            "telephone_number": "863-763-5675",
            "fax_number": "863-382-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUARELLA",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9104031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.