Individual provider Active NPI

Stephanie J Paape, MS, PA-C

  • Dermatology Physician
  • Sherman Oaks, CA
National Provider Identifier
1225636152
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
58686 Issued in CA
Practice address
4955 Van Nuys Blvd Ste 516
Sherman Oaks, CA 91403-1832
Phone
(818) 789-6296
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 58686 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 516
Sherman Oaks, CA 91403-1832

Mailing address

4955 Van Nuys Blvd Ste 516
Sherman Oaks, CA 91403-1832
Phone (818) 789-6296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211206000817 MI Practitioner - Physician Assistant 5092129247 Reassigns benefits to 1 organization
I20211211000207 WI Practitioner - Physician Assistant 5092129247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Dermatology Group LTDGroup PAC ID 9537312665, 23 clinicians
Urgent Care Physcians, LTDGroup PAC ID 0648495812, 5 clinicians

Practice addresses (Care Compare)

1606 S Stephenson Ave
Iron Mountain, MI 49801-3636
Phone (920) 965-0345

2500 E Capital Dr
Appleton, WI 54911-8735
Phone (920) 569-6549

3059 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 965-0345

3329 Express CT
Appleton, WI 54915-3278
Phone (920) 733-5900

Hospital & facility affiliations

  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Dermatology Group LTD Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.paape.1@23194.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1225636152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 516",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031832",
            "telephone_number": "818-789-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 516",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031832",
            "telephone_number": "818-789-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAAPE",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "MS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "58686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.