Stella Kocovic Villacorta, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS15031 Issued in FL

Practice address

800 E Broward Blvd Ste 103
Fort Lauderdale, FL 33301-2020

Phone

(954) 463-5406

Fax

(954) 522-2456

NPI assigned

Sep 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Stella Kocovic Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 6, 2024 through May 6, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Galt Dermatology & Concierge Medicine PA

  • Specialist
  • Fort Lauderdale, FL
  • NPI 1780964460

  Single Specialty

  NPD

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1285153239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E BROWARD BLVD STE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012020",
            "telephone_number": "954-463-5406",
            "fax_number": "954-522-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BROWARD BLVD STE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012020",
            "telephone_number": "954-463-5406",
            "fax_number": "954-522-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACORTA",
        "first_name": "STELLA",
        "middle_name": "KOCOVIC",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "KOCOVIC",
            "prefix": "MS.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ana Claudia Vigo Perez
• Shrestha Vijayendra
• Vikram Thakar DPM PA
• Richelle Anne Villa
• Miguel Villacorta, D.O., MPH
• Village Group LLC
• Ricardo Donato Villalba, LAC
• Gloria L Villalobos
• Villanueva Medical Group LLC
• Raul Villanueva, MD

• Internal Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.