NPIMap

Individual provider Active NPI

Stephanie Marie Daviduk, PA-C

  • Medical Physician Assistant
  • West Chester, PA
National Provider Identifier
1346799434
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058587 Issued in PA
Practice address
915 Old Fern Hill Rd Ste 202
West Chester, PA 19380-3431
Phone
(610) 692-4270
Fax
(610) 692-2566
NPI assigned
Sep 29, 2016
Last updated
Oct 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA058587 PA Primary

Addresses

Primary practice location

915 Old Fern Hill Rd Ste 202
West Chester, PA 19380-3431

Mailing address

915 Old Fern Hill Rd Ste 202
West Chester, PA 19380-3431
Phone (610) 692-4270

Other identifiers 1

IdentifierTypeStateIssuer
50145502OtherPACAPITAL BLUE CROSS

Other names 1

  • Stephanie Marie Meehan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216001270 PA Practitioner - Physician Assistant 3870876899 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1055 Andrew Dr
Suite 100
West Chester, PA 19380-3446
Phone (610) 692-4270

211 S Gulph Rd
Suite 200 the Prostate Center
King of Prussia, PA 19406-3101
Phone (610) 579-3577

945 Chesterbrook Blvd
Chesterbrook, PA 19087-5614
Phone (610) 273-5320

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.14 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
67.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058587PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services, PC CurrentSince Dec 30, 2017 Accepting new patients
Alliance Physician Services, PC CurrentSince Dec 30, 2017 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 1, 2017 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Radiology & MRI of Bethlehem, Inc. Past Accepting new patients
Urology Specialists of the Lehigh Valley PC Past Accepting new patients
Alliance Physician Services, PC Past Accepting new patients

Locations

1235 Old York Rd
Ste 210
Abington, PA 19001
Phone (215) 517-1100

919 Conestoga Rd
Ste 300
Bryn Mawr, PA 19010
Phone (610) 525-6580

945 Chesterbrook Blvd
Chesterbrook, PA 19087
Phone (610) 695-8088

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

500 Evergreen Dr
Ste G5
Glen Mills, PA 19342
Phone (610) 566-4383

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

2 Industrial Blvd
Ste 120
Paoli, PA 19301
Phone (610) 644-2165

140 W Germantown Pike
Ste 250
Plymouth Meeting, PA 19462
Phone (484) 530-0205

20 N Sunnybrook Rd
Pottstown, PA 19464
Phone (610) 323-5550

656 E Swedesford Rd
Ste 120
Wayne, PA 19087
Phone (610) 273-5320

1055 Andrew Dr
Ste 100
West Chester, PA 19380
Phone (610) 692-4270

915 Old Fern Hill Rd
Ste 202
West Chester, PA 19380
Phone (610) 579-3577

Organizations & group practices 10

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 8

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1346799434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD STE 202",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193803431",
            "telephone_number": "610-692-4270",
            "fax_number": "610-692-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD STE 202",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193803431",
            "telephone_number": "610-692-4270",
            "fax_number": "610-692-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDUK",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50145502",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MEEHAN",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.