Individual provider Active NPI

John Steven Stefkovich, PA

  • Medical Physician Assistant
  • Lincoln, NE
National Provider Identifier
1154322758
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
356 Issued in NE
Practice address
4501 S 70TH St
Suite 130
Lincoln, NE 68516-4282
Phone
(402) 484-4940
Fax
(402) 484-4941
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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 356 NE Primary

Addresses

Primary practice location

4501 S 70TH St
Suite 130
Lincoln, NE 68516-4282

Mailing address

8055 O St
Suite 300
Lincoln, NE 68510-2564
Phone (402) 421-0904

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
356NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Physicians Group Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1154322758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "SUITE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102564",
            "telephone_number": "402-421-0904",
            "fax_number": "402-421-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "SUITE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-484-4940",
            "fax_number": "402-484-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFKOVICH",
        "first_name": "JOHN",
        "middle_name": "STEVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.