Stephanie Barong Odoh, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114554 Issued in FL

Practice address

2727 W Dr Martin Luther King Jr Blvd Ste 630
Tampa, FL 33607-6399

Phone

(813) 397-5300

Fax

(813) 876-0590

NPI assigned

Oct 19, 2020

Last updated

Jun 27, 2023By 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 3

Addresses

Other names 1

• Stephanie Barong Clay Other 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

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.odoh.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  Medicare reassignment Care Compare group
• Tampa Family Health Centers Inc

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1356347413
  Medicare reassignment
• Tampa Family Health Centers, Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1831655380
  NPD
• Tampa Family Health Centers, Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1831769579
  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1245839521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W DR MARTIN LUTHER KING JR BLVD STE 630",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076399",
            "telephone_number": "813-397-5300",
            "fax_number": "813-876-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOH",
        "first_name": "STEPHANIE",
        "middle_name": "BARONG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114554",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14142",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "CLAY",
            "middle_name": "BARONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Julia Odell
• Odenia's Angels Alf, Corp
• Francine Odio, PSY.D.
• Brynne Odioso
• Annet Odoardo
• Denise Betty Odonnell, SLP
• Jonathan C Odonnell, PHARMD
• Carmen Natalia Odriscoll, MA OT
• Yoandris Oduardo Victoria
• Henry A Odukomaiya, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.