Individual provider Active NPI

Alexandra Marie Stine, PA

  • Physician Assistant
  • Moosic, PA
National Provider Identifier
1295198950
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058161 Issued in PA
Practice address
340 Montage Mountain Rd
Moosic, PA 18507-1707
Phone
(570) 346-3686
Fax
(570) 558-6838
NPI assigned
Mar 31, 2016
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058161 PA Primary

Addresses

Primary practice location

340 Montage Mountain Rd
Moosic, PA 18507-1707

Mailing address

340 Montage Mountain Rd
Moosic, PA 18507-1707
Phone (570) 346-3686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160531001735 PA Practitioner - Physician Assistant 9234429432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Matthew a Berger MD PCGroup PAC ID 5991791212, 51 clinicians

Practice addresses (Care Compare)

340 Montage Mountain Rd
Moosic, PA 18507-1707
Phone (570) 346-3686

340 Montage Mountain Rd
Moosic, PA 18507-1782

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
69.53
Promoting interoperability
80
Improvement activities
40
Cost
67.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058161PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Pennsylvania Inc CurrentSince Dec 4, 2019 Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

Interoperability endpoints

  • Direct secure messaging: astine@berger.medentdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1295198950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071707",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071707",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2021-09-16",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moosic, PA

Sources for this page

Verify at the official NPI Registry.