Stacey Bispham Royce, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104208 Issued in FL

Practice address

6001 21St Ave W
Bradenton, FL 34209-7847

Phone

(941) 761-4448

Fax

(941) 761-0235

NPI assigned

Aug 9, 2007

Last updated

Sep 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacey E Bispham Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Arcadia Medical Associates PA

  • Internal Medicine Physician
  • Arcadia, FL
  • NPI 1891980215
  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Physician Assistant

  Medicare reassignment NPD
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Cardiovascular Solutions Institute Outpatient Services, LLC

  • Cardiovascular Disease Physician
  • Bradenton, FL
  • NPI 1487125035
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1205027620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097847",
            "telephone_number": "941-761-4448",
            "fax_number": "941-761-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097847",
            "telephone_number": "941-761-4448",
            "fax_number": "941-761-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYCE",
        "first_name": "STACEY",
        "middle_name": "BISPHAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA9104208",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BISPHAM",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Claire Rowell, LCSW
• Robin R. Rowland, LMT
• Roy Arron Parker, DMD, P
• Amy L Royall, M.S., CCC-SLP
• Jacqueline Frannie Royce, D.O.
• Michael Rozak, MD
• Michael T Rozmus, OT/CHT
• RP Hearing, LLC
• RS. VA Holdings LLC (Doc Smith)
• RSC Bradenton Langdon LLC

• Physician Assistant in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.