Individual provider Active NPI

Stephen Benjamin Crosby, PA-C

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1639321920
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005461 Issued in GA
Practice address
840 Stevens Creek Road
Augusta, GA 30907
Phone
(706) 722-6957
Fax
(706) 722-7454
NPI assigned
Oct 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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 005461 GA Primary

Addresses

Primary practice location

840 Stevens Creek Road
Augusta, GA 30907

Mailing address

University Medical Group, LLC
PO Box 1705
Augusta, GA 30903-1705
Phone (706) 854-6917

Other practice location 1

3486 Peach Orchard Rd Ste 200
Augusta, GA 30906-5215
Phone (706) 828-8049

Other practice location 2

4720 Washington Rd
Evans, GA 30809-5875
Phone (706) 650-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20090128000270 GA Practitioner - Physician Assistant 7214091701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W 2200
Fayetteville, GA 30214-2110
Phone (470) 271-3415

Hospital & facility affiliations

  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Group LLC CurrentSince May 1, 2014 Accepting new patients
University Prompt Care Current Accepting new patients
University Health Care Physicians LLC Current Accepting new patients
University Primary Care Current Accepting new patients
University Medical Group LLC CurrentSince May 1, 2014 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

820 Saint Sebastian Way
Ste 4C
Augusta, GA 30901
Phone (706) 774-5997

447 N Belair Rd
Ste 101
Evans, GA 30809
Phone (706) 854-2222

4720 Washington Rd
Evans, GA 30809
Phone (706) 650-0111

Organizations & group practices 7

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 1

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1639321920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY MEDICAL GROUP, LLC",
            "address_2": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-854-6917",
            "fax_number": "706-774-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 STEVENS CREEK ROAD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30907",
            "telephone_number": "706-722-6957",
            "fax_number": "706-722-7454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3486 Peach Orchard Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309065215",
            "country_code": "US",
            "telephone_number": "706-828-8049",
            "fax_number": "706-828-8048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4720 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308095875",
            "country_code": "US",
            "telephone_number": "706-650-0111",
            "fax_number": "706-651-1882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "STEPHEN",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-17",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.