Stephanie Wade

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10026 Issued in TX

Practice address

7777 Forest LN
Dallas, TX 75230

Phone

(972) 566-7000

NPI assigned

Aug 20, 2015

Last updated

Jun 15, 2018By 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 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Cny Fertility Center

  • Reproductive Endocrinology Physician
  • Syracuse, NY
  • NPI 1568504298
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1558737817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-566-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Forest Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752302571",
            "country_code": "US",
            "telephone_number": "972-566-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "1558737817",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31827764",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356244903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8HN475",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "626721YKT8",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jermaine Wade
• Lily Anabelle Wade
• Nataria Wade, LMSW
• Paul D Wade, M.D.
• Ryan Wade, CRNA
• Tenaya Wade
• Sonia Wadekar, MD
• Melissa Dawn Waden, MSSW, LMSW,
• Anupama N Wadhwa, MD
• Anvita Wadhwa

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.