Mary Rebecca Stoll, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

L1397712 Issued in MI

Practice address

4170 Cedar Bluff Dr
Petoskey, MI 49770-7627

Phone

(231) 487-2230

Fax

(231) 487-6172

NPI assigned

Sep 3, 2008

Last updated

Jul 21, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Michigan PCGroup PAC ID 0941511224, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133

Merit-based Incentive Payment System (MIPS)

Final score

84.2 of 100Reported as group

Quality

81.43

Promoting interoperability

82

Improvement activities

40

Cost

80.91

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.stoll@adcs1.emadirect.md

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.

• Advanced Dermatology of Michigan PC

  • Dermatology Physician
  • Wyandotte, MI
  • NPI 1851708929
  Medicare reassignment Care Compare group
• Village Chiropractic Wellness Center, PLC

  • Chiropractor
  • Kalkaska, MI
  • NPI 1710149844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1083862098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 CEDAR BLUFF DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707627",
            "telephone_number": "231-487-2230",
            "fax_number": "231-487-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 CEDAR BLUFF DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707627",
            "telephone_number": "231-487-2230",
            "fax_number": "231-487-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLL",
        "first_name": "MARY",
        "middle_name": "REBECCA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "L1397712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Stephenson, CCAR
• Emily R Stevens, MD
• Kennedy Steward
• Stieber Pediatric Dentistry PLLC (Petoskey Pediatric Dentistry)
• Still Space Counseling LLC
• Loralee M Streelman, ATR-BC,LCPC
• Sean Joseph Stringer, D.D.S.
• Bryan T Stump, DMD
• Michele Sturt, CFNP
• Drew E Styma, ATC

• Physician Assistant in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.