Individual provider Active NPI

Stephanie Chery, PA-C

  • Physician Assistant
  • Tamarac, FL
National Provider Identifier
1376007278
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111877 Issued in FL
Practice address
7421 N University Dr Ste 107
Tamarac, FL 33321-2952
Phone
(954) 726-0095
NPI assigned
Jan 24, 2019
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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 9111877 FL Primary

Addresses

Primary practice location

7421 N University Dr Ste 107
Tamarac, FL 33321-2952

Mailing address

7852 NW 62ND Ter
Parkland, FL 33067-3349
Phone (954) 397-5263

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
I20190403002621 FL Practitioner - Physician Assistant 1355682139 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111877FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: stephanie.chery@hca4.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1376007278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7852 NW 62ND TER",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330673349",
            "telephone_number": "954-397-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 107",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212952",
            "telephone_number": "954-726-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERY",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.