Individual provider Active NPI

Stephanie Aldridge, PA-C

  • Surgical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1194487157
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9115147 Issued in FL
Practice address
625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629
Phone
(727) 898-2663
Fax
(727) 568-6836
NPI assigned
Oct 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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 9115147 FL
Surgical Physician Assistant 363AS0400X PA9115147 FL Primary

Addresses

Primary practice location

625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629

Mailing address

625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629
Phone (727) 898-2663

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
I20220522000043 FL Practitioner - Physician Assistant 7214314749 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9115147FLMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: saldridge942293@direct.hopkinsmedicine.org

Organizations & group practices 1

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1194487157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 6TH AVE S STE 450",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014629",
            "telephone_number": "727-898-2663",
            "fax_number": "727-568-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 6TH AVE S STE 450",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014629",
            "telephone_number": "727-898-2663",
            "fax_number": "727-568-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDRIDGE",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9115147",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.