Individual provider Active NPI

Stephanie Chen, PA

  • Physician Assistant
  • East Orange, NJ
National Provider Identifier
1215459169
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00438900 Issued in NJ
Practice address
300 Central Ave
East Orange, NJ 07018-2819
Phone
(973) 672-8400
NPI assigned
Jul 12, 2017
Last updated
May 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00438900 NJ Primary
Physician Assistant 363A00000X 66256 CA

Addresses

Primary practice location

300 Central Ave
East Orange, NJ 07018-2819

Mailing address

11 Washington PL Apt 202
Cliffside Park, NJ 07010-1277

Other practice location 1

2740 Fulton Ave Ste 220
Sacramento, CA 95821-5186
Phone (908) 663-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, AR, CA, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170920002071 NJ Practitioner - Physician Assistant 6608140280 Reassigns benefits to 3 organizations
I20231209000794 AR Practitioner - Physician Assistant 6608140280 Reassigns benefits to 1 organization
I20260108001268 CA Practitioner - Physician Assistant 6608140280 Reassigns benefits to 1 organization
I20260327000083 NY Practitioner - Physician Assistant 6608140280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rutgers New Jersey Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stationmd Professional CorporationGroup PAC ID 6204184104, 64 clinicians

Practice addresses (Care Compare)

11 Washington PL
Apt 202
Cliffside Park, NJ 07010-1277
Phone (908) 663-2929

4885 Route 9
Staatsburg, NY 12580-6028
Phone 9086632929898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66256CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stationmd California PC CurrentSince Oct 1, 2025 Accepting new patients

Locations

2740 Fulton Ave
Ste 220
Sacramento, CA 95821
Phone (877) 782-8637

515 Valley St
Ste 203
Maplewood, NJ 07040
Phone 9086632929800

Organizations & group practices 5

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1215459169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WASHINGTON PL APT 202",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTRAL AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182819",
            "telephone_number": "973-672-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 Fulton Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958215186",
            "country_code": "US",
            "telephone_number": "908-663-2929",
            "fax_number": "908-934-9564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00438900",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.