Individual provider Active NPI

Stephanie Wang, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1558243154
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120992 Issued in FL
Practice address
615 E Princeton St Ste 310
Orlando, FL 32803-1468
Phone
(407) 303-5781
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X PA9120992 FL Primary

Addresses

Primary practice location

615 E Princeton St Ste 310
Orlando, FL 32803-1468

Mailing address

615 E Princeton St Ste 310
Orlando, FL 32803-1468
Phone (407) 303-5781

Other practice location 1

8 Foxtail Ct
Newark, DE 19711-4377
Phone (305) 606-0657

Other practice location 2

1305 Morgan Stanley Ave
Winter Park, FL 32789-1944
Phone (305) 606-0657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260302001179 FL Practitioner - Physician Assistant 3476035353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

615 E Princeton St
Suite 310
Orlando, FL 32803-1468

900 Hope Way
Altamonte Springs, FL 32714-1502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9120992FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Apr 20, 2026 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Apr 20, 2026 Accepting new patients

Locations

615 E Princeton St
Ste 310
Orlando, FL 32803
Phone (407) 303-5781

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1558243154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 310",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031468",
            "telephone_number": "407-303-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 310",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031468",
            "telephone_number": "407-303-5781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Foxtail Ct",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197114377",
            "country_code": "US",
            "telephone_number": "305-606-0657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1305 Morgan Stanley Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327891944",
            "country_code": "US",
            "telephone_number": "305-606-0657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.