Individual provider Active NPI

Pamela Jean Stoike, PAC

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1609854876
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9108871 Issued in FL
Practice address
4215 Edgewater Dr
Orlando, FL 32804-2206
Phone
(973) 826-8080
Fax
(888) 972-6480
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002539 IL
Surgical Physician Assistant 363AS0400X PA9108871 FL Primary

Addresses

Primary practice location

4215 Edgewater Dr
Orlando, FL 32804-2206

Mailing address

PO Box 4059
Wayne, NJ 07474-4059
Phone (973) 826-8080

Other identifiers 3

IdentifierTypeStateIssuer
P00339334OtherILMEDICARE RAILROAD
02222323OtherILBCBS
IS471WOtherFLQSS SOUTHEAST CLINICAL SERVICES - PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085002539ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Select, Inc. Physician Assistant PastSince Dec 17, 2020 Accepting new patients
Health Consulting Associates LLC PastSince Oct 20, 2015 Accepting new patients
QSS-Southeast Clinical Services LLC PastSince Jun 12, 2017 Accepting new patients
Orthopedic Specialists SC Physician Assistant Past Accepting new patients
Southeastern Clinical Services,Inc. Surgical PastSince Jun 5, 2012 Accepting new patients

Organizations & group practices 5

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609854876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4059",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074744059",
            "telephone_number": "973-826-8080",
            "fax_number": "888-972-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328042206",
            "telephone_number": "973-826-8080",
            "fax_number": "888-972-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOIKE",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002539",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9108871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00339334",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02222323",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QSS SOUTHEAST CLINICAL SERVICES -  PTAN",
            "identifier": "IS471W",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.