Individual provider Active NPI

Jason M. Stella, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1457590705
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2009002138 Issued in MO
Practice address
2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239
Phone
(417) 820-3960
Fax
(417) 820-3966
NPI assigned
Feb 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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 2009002138 MO Primary

Addresses

Primary practice location

2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090416000598 MO Practitioner - Physician Assistant 8426105081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Dec 1, 2023 Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

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.

Hospital & facility affiliations 9

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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1457590705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE",
            "address_2": "SUITE 5000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042239",
            "telephone_number": "417-820-3960",
            "fax_number": "417-820-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLA",
        "first_name": "JASON",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009002138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.