Stacey Stefansky DPM PLLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

5901002115 Issued in MI

Legal business name

STACEY STEFANSKY DPM PLLC

Practice address

2130 Marshall Court
Waterford, MI 48329-4069

Phone

(248) 390-5730

NPI assigned

Feb 10, 2009

Organization subpart

No

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

Authorized official

Name

Stacey Stefansky, DPMNPI 1053399949

Title

Owner

Phone

(248) 390-5730

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacey Ann Stefansky, DPM

  • Foot & Ankle Surgery Podiatrist
  • Livonia, MI
  • NPI 1053399949
  Medicare reassignment Care Compare group Authorized official
• Randy Semma, DPM

  • Podiatrist
  • Commerce TWP, MI
  • NPI 1386933125
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1194964452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300965",
            "city": "DRAYTON PLAINS",
            "state": "MI",
            "postal_code": "483300965",
            "telephone_number": "248-390-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MARSHALL COURT",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294069",
            "telephone_number": "248-390-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY STEFANSKY DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "STEFANSKY",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-390-5730",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MI",
            "license": "5901002115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053399949",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4856320100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Catherine Spellman, PHARMD
• Kimberley Lynn Spencer-Ion, DNP, FNP-C
• Richard James St Louis, O.D.
• Jan St. Germain, OTR/L
• Anne Marie St. Louis, O.D.
• Cindy Marie Stader, LMSW
• Wendy Lee Standifer, MA, LPC, NCC
• Stanford C Rapp DO PC
• Stanford C. Rapp, D.O., P.C.
• Stannard and Studt Dentistry PC

• Podiatric Clinic/Center in Waterford, MI
• Providers in Waterford, MI by specialty
• Podiatric Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.