Stephany Matallana, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

774 State Road 13 N
Saint Johns, FL 32259-3857

Phone

(904) 224-5437

Fax

(904) 647-2692

NPI assigned

Jan 24, 2023

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physicians Inc

  dba Emergency Resources Group

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  Medicare reassignment NPD
• Angel Kids PA

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1124162854
  NPD (past)

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1609582543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 STATE ROAD 13 N",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322593857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 STATE ROAD 13 N",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322593857",
            "telephone_number": "904-224-5437",
            "fax_number": "904-647-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATALLANA",
        "first_name": "STEPHANY",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren J Marchefka, FNP
• Larissa Marie Marchetti, PHARMD
• Mary S Marshall
• Kanaklakshmi Masodkar, MD
• Michele Mason
• Mary Stephens Mathis, PA-C
• Jennifer Sue Matthews, PA-C
• Maxwell Behavioral Health
• Erin Leigh Maxwell, PHARMD
• Gabriela May

• Physician Assistant in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.