Individual provider Active NPI

Stacey B Schmidt, PA-C

  • Physician Assistant
  • Trinity, FL
National Provider Identifier
1205920493
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103625 Issued in FL
Practice address
2160 Duck Slough Blvd Ste 103
Trinity, FL 34655-5007
Phone
(727) 807-9070
Fax
(727) 807-5801
NPI assigned
Oct 3, 2006
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103625 FL Primary

Addresses

Primary practice location

2160 Duck Slough Blvd Ste 103
Trinity, FL 34655-5007

Mailing address

2160 Duck Slough Blvd Ste 103
Trinity, FL 34655-5007
Phone (727) 807-9070

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
I20080317000543 FL Practitioner - Physician Assistant 1658476866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of the Palm Beaches PLLCGroup PAC ID 6709861602, 13 clinicians
Midstate Skin Institute LLCGroup PAC ID 3870746605, 18 clinicians

Practice addresses (Care Compare)

10335 N Military TRL
Suite a
Palm Beach Gardens, FL 33410-4634
Phone (561) 659-1510

1551 Forum PL
Suite 100a
West Palm Beach, FL 33401-2305

2160 Duck Slough Blvd
Suite 103
Trinity, FL 34655-5007
Phone (727) 807-9070

3210 SW 33Rd Rd
Suite 101
Ocala, FL 34474-7409
Phone (352) 512-0092

400 Executive Ctr Dr
Suite 110
West Palm Beach, FL 33401-2919
Phone (561) 659-1510

7648 SW 61St Ave
Suite 100
Ocala, FL 34476-8310
Phone (352) 512-0092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lumen Dermatology LLC PastSince Mar 1, 2025 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1205920493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 DUCK SLOUGH BLVD STE 103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555007",
            "telephone_number": "727-807-9070",
            "fax_number": "727-807-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 DUCK SLOUGH BLVD STE 103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555007",
            "telephone_number": "727-807-9070",
            "fax_number": "727-807-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "STACEY",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.