Stephanie Saal Aviles, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5910 Issued in MA

Practice address

Enfield Medical Associates
701 Enfield Street
Enfield, CT 06082

Phone

(860) 741-6058

Fax

(413) 733-5860

NPI assigned

Aug 29, 2013

Last updated

Dec 7, 2022By 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 3

Addresses

Other identifiers 1

Other names 1

• Stephanie Saal Aviles Former name

Medicare fee-for-service enrollment

Enrolled in MA, CT2 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

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.

• Riverbend Medical Group, Inc.

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197
  Medicare reassignment NPD
• Riverbend Medical Group, Inc

  dba Trinity Health Of New England Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• Mwa, PC

  dba RiverBend Medical Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Chicopee, MA
  • NPI 1427280791
  NPD (past)
• Riverbend Medical Group, Inc

  dba Trinity Health Of New England Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1639280779
  NPD (past)

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1487088241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SPRINGFIELD MEDICAL ASSOCIATES, INC",
            "address_2": "2150 MAIN STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01104",
            "telephone_number": "413-739-5676",
            "fax_number": "413-733-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ENFIELD MEDICAL ASSOCIATES",
            "address_2": "701 ENFIELD STREET",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "06082",
            "telephone_number": "860-741-6058",
            "fax_number": "413-733-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "STEPHANIE",
        "middle_name": "SAAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA-4817",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4817",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "5910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110110336A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "AVILES",
            "middle_name": "SAAL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Enfield, CT
• Providers in Enfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.

Verify at the official NPI Registry.