Individual provider Active NPI

Stephanie Ann Hutchison, D.O.

  • Internal Medicine Physician
  • Wynnewood, PA
National Provider Identifier
1568695682
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS015603 Issued in PA
Practice address
100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450
Phone
(484) 476-6421
Fax
(484) 476-3149
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS015603 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450
Phone (484) 476-6421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000253 PA Practitioner - Internal MedicinePractitioner - Hospitalist 0648458893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel C Lazowick DO LLCGroup PAC ID 3870748130, 2 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Suite 461
Wynnewood, PA 19096-3434
Phone (610) 649-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS015603PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Apr 1, 2014 Accepting new patients
Daniel C Lazowick DO LLC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

100 E Lancaster Ave
Ste 4303
Wynnewood, PA 19096
Phone (484) 476-6421

100 E Lancaster Ave
Ste 461
Wynnewood, PA 19096
Phone (610) 642-2570

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Interoperability endpoints

  • Direct secure messaging: stephanie.hutchison.1@14079.direct.athenahealth.com

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.

Hospital & facility affiliations 7

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": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1568695682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "4 PAVILION, SUITE 4303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "4 PAVILION, SUITE 4303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS015603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.