Individual provider Active NPI

Dolores A Stefanski, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1295070647
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2726932 Issued in FL
Practice address
5510 N Hesperides St
Tampa, FL 33614-5414
Phone
(813) 467-6111
Fax
(813) 467-6111
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2726932 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2726932 FL Primary

Addresses

Primary practice location

5510 N Hesperides St
Tampa, FL 33614-5414

Mailing address

11528 US Highway 19
Port Richey, FL 34668-1442
Phone (727) 868-2151

Other practice location 1

725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242

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
I20131202000589 FL Practitioner - Nurse Practitioner 7012143753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2726932FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellbeing LLC CurrentSince Mar 1, 2022 Accepting new patients
MCR Health, Inc. CurrentSince Jun 23, 2022 Accepting new patients
MCR Health, Inc. CurrentSince Jun 23, 2022 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

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.

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1295070647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346681442",
            "telephone_number": "727-868-2151",
            "fax_number": "727-868-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 N HESPERIDES ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145414",
            "telephone_number": "813-467-6111",
            "fax_number": "813-467-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFANSKI",
        "first_name": "DOLORES",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "2726932",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2726932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.