Individual provider Active NPI

Stephanie Burns, PA-C

  • Physician Assistant
  • Greenwood, IN
National Provider Identifier
1578865069
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002098A Issued in IN
Practice address
875 Airport Pkwy
Greenwood, IN 46143-1085
Phone
(317) 926-3739
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002098A IN Primary

Addresses

Primary practice location

875 Airport Pkwy
Greenwood, IN 46143-1085

Mailing address

875 Airport Pkwy
Greenwood, IN 46143-1085
Phone (317) 926-3739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160907001696 IN Practitioner - Physician Assistant 2769627587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Inc.Group PAC ID 4587604962, 20 clinicians

Practice addresses (Care Compare)

875 Airport Pkwy
Greenwood, IN 46143-1085
Phone (317) 926-3739

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10002098AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Inc CurrentSince Aug 29, 2016 Accepting new patients
Major Hospital Past Accepting new patients
Derick Dermatology, PLLC Past Accepting new patients

Locations

875 Airport Pkwy
Greenwood, IN 46143
Phone 31792637395155

533 E County Line Rd
Ste 203
Greenwood, IN 46143

3755 E 82nd St
Ste 75
Indianapolis, IN 46240

1722 S Memorial Dr
Ste F
New Castle, IN 47362

Organizations & group practices 4

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1578865069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 AIRPORT PKWY",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431085",
            "telephone_number": "317-926-3739",
            "fax_number": "317-931-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 AIRPORT PKWY",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431085",
            "telephone_number": "317-926-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002098A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.