Stacey Epperson Moffitt, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA.264 Issued in AL

Practice address

701 University Blvd E Ste 606
Tuscaloosa, AL 35401-7411

Phone

(205) 752-2501

Fax

(205) 759-5874

NPI assigned

Jun 16, 2006

Last updated

Jul 26, 2019By 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 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Physician Assistant

Education

University of Alabama School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Physician Network, P.C.Group PAC ID 0840337721, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Merit-based Incentive Payment System (MIPS)

Final score

80.71 of 100Reported as group

Quality

65.41

Promoting interoperability

90

Improvement activities

40

Cost

78.61

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southeast Physician Network, P.C.

  • Hematology & Oncology Physician
  • Tuscaloosa, AL
  • NPI 1598090839
  Medicare reassignment Care Compare group NPD
• The Radiology Clinic LLC

  • Diagnostic Radiology Physician
  • Tuscaloosa, AL
  • NPI 1649235243
  NPD (past)
• West Alabama Orthopaedic and Sports Medicine, PC

  • Orthopaedic Surgery Physician
  • Northport, AL
  • NPI 1760420384
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The DCH Health Care Authority

  dba DCH Health & Wellness Clinic

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1306613211

  Hospital

  Care Compare affiliation
• The DCH Health Care Authority

  dba DCH Outpatient Services

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1780927681

  Hospital

  Care Compare affiliation
• The DCH Healthcare Authority

  dba DCH Regional Medical Center

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1447294582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 606",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017411",
            "telephone_number": "205-752-2501",
            "fax_number": "205-759-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 606",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017411",
            "telephone_number": "205-752-2501",
            "fax_number": "205-759-5874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Paul Bryant Dr E",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354012094",
            "country_code": "US",
            "telephone_number": "205-345-0192",
            "fax_number": "205-247-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "STACEY",
        "middle_name": "EPPERSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA-264",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA.264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051504089",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51504089",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susana Mixson, PHARM.D.
• Shirley Jean Mizell, RN, HEALTH EDUCATOR
• Ally Pritchett Mizerany
• MJM GTT Spa LLC
• Modern Day Living Cerified Residential Facility
• Shuaib Mohamed, M.D.
• Mark Mohler, M.S., ATC
• Brian M Monroe, PHD, LMFT
• Margaret Anne Monroe, LMFTA
• Justin Scott Montgomery, DNP, CRNA

• Surgical Physician Assistant in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Surgical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.