Stephanie Gabrielle Von Pahlen-Fedoroff, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4619 Issued in AZ

Practice address

500 W Thomas Rd Ste 400
Phoenix, AZ 85013-4238

Phone

(602) 406-3874

Fax

(602) 406-2335

NPI assigned

Jun 14, 2006

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph'S Hospital and Medical CenterGroup PAC ID 6709863178, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

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 and National Provider Directory roles.

• St. Joseph'S Hospital and Medical Center

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  Medicare reassignment Care Compare group
• Sjhmc Physician Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  Medicare reassignment
• St Josephs Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1265407738
  NPD
• Gustafson Orthopedics, Inc.

  • Specialist
  • Loma Linda, CA
  • NPI 1386827988
  NPD (past)

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

• Dignity Health

  • Emergency Care Clinic/Center
  • Litchfield Park, AZ
  • NPI 1265065445

  Hospital

  Care Compare affiliation
• Dignity Health

  • Emergency Care Clinic/Center
  • Glendale, AZ
  • NPI 1609408665

  Hospital

  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1982733655
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1992131734
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1497798573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134238",
            "telephone_number": "602-406-3874",
            "fax_number": "602-406-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON PAHLEN-FEDOROFF",
        "first_name": "STEPHANIE",
        "middle_name": "GABRIELLE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4619",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Anna Von Borries Valenti, FNP-C
• Tanya Kalani Von Detten, M.D.
• Monica Von Eggers, PHD, LPC, LISAC, NCC
• Eric Von Hess, P.T.
• Kara Von Kolen, DNP, WHNP-BC
• Von Rice Chiropractic and Acupuncture LLC
• Kurt G. Von Rice, D.C.
• Nicole Vondrasek
• Brittany Lee Vondross, RN
• Karla M. Vonehrenkrook, PHD

• Surgical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.