Individual provider Active NPI

Stefanie Marie Alvis, PA-C

  • Medical Physician Assistant
  • Advance, NC
National Provider Identifier
1114207065
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-05137 Issued in NC
Practice address
108 Dornach Way
Advance, NC 27006-7305
Phone
(336) 940-2407
Fax
(336) 940-2406
NPI assigned
Aug 24, 2011
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-05137 NC Primary

Addresses

Primary practice location

108 Dornach Way
Advance, NC 27006-7305

Mailing address

108 Dornach Way
Advance, NC 27006-7305
Phone (336) 940-2407

Other names 1

  • Ms. Stefanie Marie Neel Former name

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
I20141015000125 NC Practitioner - Physician Assistant 1759553183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davie Dermatology, P.a.Group PAC ID 0547241580, 13 clinicians

Practice addresses (Care Compare)

108 Dornach Way
Bermuda Run, NC 27006-7305
Phone (336) 940-2407

Merit-based Incentive Payment System (MIPS)

Final score
94.59 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
81.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
550WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences PastSince Apr 6, 2021 Accepting new patients
Derm One, PLLC 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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1114207065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 DORNACH WAY",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067305",
            "telephone_number": "336-940-2407",
            "fax_number": "336-940-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 DORNACH WAY",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067305",
            "telephone_number": "336-940-2407",
            "fax_number": "336-940-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVIS",
        "first_name": "STEFANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-05137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "NEEL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Advance, NC

Sources for this page

Verify at the official NPI Registry.