Stephanie A Rea, PAC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5601005671 Issued in MI

Practice address

8338 Allen Road
Suite 101
Allen Park, MI 48101

Phone

(313) 386-5500

Fax

(313) 386-1339

NPI assigned

Nov 5, 2009

Last updated

Mar 9, 2016By 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 2

Addresses

Other identifiers 1

Other names 1

• Stephanie A Manduzzi Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Merit-based Incentive Payment System (MIPS)

Final score

91.69 of 100Reported as group

Quality

95.66

Promoting interoperability

98

Improvement activities

40

Cost

78.3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: stephanierea@wwp.allscriptsdirect.net

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.

• Western Wayne Family Physicians, PLC

  dba Western Wayne Physicians, PLC

  • Family Medicine Physician
  • Allen Park, MI
  • NPI 1629263520
  Medicare reassignment

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1356678866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8338 ALLEN ROAD",
            "address_2": "SUITE 101",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-386-5500",
            "fax_number": "313-386-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8338 ALLEN ROAD",
            "address_2": "SUITE 101",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-386-5500",
            "fax_number": "313-386-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005671",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601005671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LISC",
            "identifier": "5601005671",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MANDUZZI",
            "middle_name": "A",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• R N Home Health Care, PLLC
• Eqdam N Radhi, MD
• Ralph W Raper MD PC
• Umadevi Ramachandran, RPT
• Mustafa Raychouni, DC
• Joseph Fred Recknagel, A.T.C.
• Ashley A Reed, ATC
• Marcia A Regalado, RN
• Ateeq K Rehman, M.D.
• Makayla Dawn Reid, DDS

• Family Medicine Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.