Active NPI
Samuel Aaron Stephenson, MD
- Pediatrics Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME113422
- Practice address
- 5900 S John Young Pkwy
Orlando, FL 32839-3716 - Phone
- (407) 398-6470
- Fax
- (407) 894-6872
- NPI assigned
- Jul 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME113422 | FL | Primary |
Addresses
Primary practice location
5900 S John Young Pkwy
Orlando, FL 32839-3716
Mailing address
5900 South John Young Pkwy
Orlando, FL 32839
Phone (407) 398-6470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006440100 | Medicaid | FL |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME113422 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Florida Emergency Management LLC | Current | Accepting new patients | |
| Emergency Medicine Services of FL, LLC | Current | Accepting new patients |
Locations
322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858
14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929
700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
350 7th St N
Naples, FL 34102
Phone (239) 436-5000
11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721
105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Aventura, FL
- NPI 1043917180
-
- Emergency Medicine Physician
- Naples, FL
- NPI 1780911206
-
- Emergency Medicine Physician
- Jacksonville, FL
- NPI 1285686675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1407085798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 SOUTH JOHN YOUNG PKWY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32839",
"telephone_number": "407-398-6470",
"fax_number": "407-894-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 S JOHN YOUNG PKWY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328393716",
"telephone_number": "407-398-6470",
"fax_number": "407-894-6872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "SAMUEL",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-08",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME113422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006440100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.