Carley Fern Stevenson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3261 W State Rd
Saint Bonaventure, NY 14778-9800

Phone

(248) 535-7880

NPI assigned

Feb 2, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary Imogene Bassett Hospital

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment Care Compare group NPD
• Mary Imogene Bassett Hospital

  • Specialty Pharmacy
  • Oneonta, NY
  • NPI 1174419196
  NPD

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

• Mary Imogene Bassett Hospital

  • Rural Acute Care Hospital
  • Cooperstown, NY
  • NPI 1780600577
  Care Compare affiliation

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1154027092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 W STATE RD",
            "city": "SAINT BONAVENTURE",
            "state": "NY",
            "postal_code": "147789800",
            "telephone_number": "248-535-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 W STATE RD",
            "city": "SAINT BONAVENTURE",
            "state": "NY",
            "postal_code": "147789800",
            "telephone_number": "248-535-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "CARLEY",
        "middle_name": "FERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NEN757030452487",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nguyen
• Francesca Parry, NP
• Jesus R Perez Jr., PA-C
• Matt Smith, LAT, ATC
• St. Bonaventure University
• Gianna Marie Trillo
• Nicole Elise Tschiderer
• Diane Vu

• Physician Assistant in Saint Bonaventure, NY
• Providers in Saint Bonaventure, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.