Individual provider Active NPI

Stephen Michael Delellis, PA-C

  • Physician Assistant
  • Hope Mills, NC
National Provider Identifier
1366652125
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103216 Issued in NC
Practice address
3622 N Main St
Hope Mills, NC 28348-1937
Phone
(910) 423-7771
Fax
(910) 423-4177
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 103216 NC Primary

Addresses

Primary practice location

3622 N Main St
Hope Mills, NC 28348-1937

Mailing address

136 Timberlake Dr
Fayetteville, NC 28314-1240
Phone (910) 643-0729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210824002656 NC Practitioner - Physician Assistant 5597907444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

3622 N Main St
Hope Mills, NC 28348-1937
Phone (910) 423-7771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Apr 1, 2025 Accepting new patients
FHPG, LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

3622 N Main St
Hope Mills, NC 28348
Phone (910) 321-0006

Interoperability endpoints

  • Direct secure messaging: sdelellis125649@firsthealth.direct-ci.net

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 4

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1366652125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 TIMBERLAKE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141240",
            "telephone_number": "910-643-0729",
            "fax_number": "910-643-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 N MAIN ST",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283481937",
            "telephone_number": "910-423-7771",
            "fax_number": "910-423-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELELLIS",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hope Mills, NC

Sources for this page

Verify at the official NPI Registry.