Individual provider Active NPI

Alexis M. Stephens, PA-C

  • Physician Assistant
  • Cooperstown, NY
National Provider Identifier
1427543859
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Atwell Rd
Cooperstown, NY 13326
Phone
(607) 547-3456
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 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 Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

Other practice location 1

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3456

Other names 1

  • Alexis M. Ebersole Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180910000470 NY Practitioner - Physician Assistant 5395095541 Reassigns benefits to 2 organizations
I20220325000339 WV Practitioner - Physician Assistant 5395095541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2596WVMDMental Health Counselor
022271NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Education Building-Urgent Care CurrentSince Jan 1, 2022 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2022 Accepting new patients
West Virginia University Medical Corporation Past Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

  • Direct secure messaging: aebersole326817@bassett.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1427543859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "13326",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "ALEXIS",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "EBERSOLE",
            "middle_name": "M.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.