Individual provider Active NPI

Stephanie Carmen Oberweger, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1164934006
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9110779 Issued in FL
Practice address
8124 Chianti Dr
Orlando, FL 32836-5311
Phone
(407) 797-3630
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9110779 FL
Medical Physician Assistant 363AM0700X PA9110779 FL Primary

Addresses

Primary practice location

8124 Chianti Dr
Orlando, FL 32836-5311

Mailing address

8124 Chianti Dr
Orlando, FL 32836-5311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210208002529 FL Practitioner - Physician Assistant 3678988474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.42 of 100Reported as group
Quality
81.82
Promoting interoperability
79
Improvement activities
40
Cost
80.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110779FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC PastSince Aug 30, 2021 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": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1164934006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8124 CHIANTI DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8124 CHIANTI DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365311",
            "telephone_number": "407-797-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERWEGER",
        "first_name": "STEPHANIE",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9110779",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.