NPIMap

Individual provider Active NPI

Stephanie M Pevarnik, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1477965085
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0005177 Issued in MD
Practice address
301 Saint Paul St
Baltimore, MD 21202-2102
Phone
(410) 539-2227
NPI assigned
May 30, 2014
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110004357 VA
Physician Assistant 363A00000X C0005177 MD Primary

Addresses

Primary practice location

301 Saint Paul St
Baltimore, MD 21202-2102

Mailing address

301 Saint Paul St
Baltimore, MD 21202-2102
Phone (410) 539-2227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140924000117 MD Practitioner - Physician Assistant 6800015835 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

301 Saint Paul St
Baltimore, MD 21202-2102

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0005177MDMDPhysician Assistant
0110004357VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Aug 14, 2014 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Aug 14, 2014 Accepting new patients
St Paul Place Specialists Inc CurrentSince Apr 30, 2018 Accepting new patients
St Paul Place Specialists, Inc. Physician Assistant CurrentSince Apr 30, 2018 Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2411 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-8314

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: sjohnson40060@direct.mdmercy.com

Organizations & group practices 10

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.

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": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1477965085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-539-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-539-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVARNIK",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-30",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004357",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.