Victor Louis Stava, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06412 Issued in TX

Practice address

2857 W Washington St
Stephenville, TX 76401-3706

Phone

(254) 965-5273

NPI assigned

Aug 31, 2007

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group
• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment
• C,L and W PLLC

  dba Affordacare

  • Urgent Care Clinic/Center
  • Abilene, TX
  • NPI 1619235629
  Medicare reassignment
• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment
• Parker Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Weatherford, TX
  • NPI 1689923740

  Physician Assistant

  NPD (past)
• North Platte Nebraska Physician Group LLC

  • Emergency Medicine Physician
  • North Platte, NE
  • NPI 1740465715

  Medical

  NPD (past)

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1154515245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 GRINDSTONE RD UNIT 202",
            "city": "BROCK",
            "state": "TX",
            "postal_code": "760879676",
            "telephone_number": "817-304-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013706",
            "telephone_number": "254-965-5273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3520 NW Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761353612",
            "country_code": "US",
            "telephone_number": "972-745-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVA",
        "first_name": "VICTOR",
        "middle_name": "LOUIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1011",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280383501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01239581",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280383502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Bailey Smith
• Sheryl Smith, PTA
• Celia Spoon, LPC ASSOCIATE
• David Lee Stanphill, D.D.S
• Star Council on Substance Abuse
• Jacek Stepczynski, PT
• Stephen's Health Care, Inc.
• Stephens Memorial Hospital District (Avir at Stephenville)
• Stephenville 2108 ER Physicians PLLC
• Stephenville Complete UC & Family Medicine PLLC

• Physician Assistant in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.