NPIMap

Individual provider Active NPI

Stephania Dejno

  • Family Nurse Practitioner
  • Fleming Island, FL
National Provider Identifier
1639636194
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004024 Issued in FL
Practice address
4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822
Phone
(904) 269-4559
Fax
(904) 269-4597
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11004024 FL Primary

Addresses

Primary practice location

4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (833) 702-8383

Other identifiers 1

IdentifierTypeStateIssuer
105481400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200220000916 FL Practitioner - Nurse Practitioner 4981031580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Family Care Partners of Northeast Florida LLCGroup PAC ID 7214832245, 15 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

4565 US Hwy 17
Suite 106
Fleming Island, FL 32003-4822
Phone (904) 269-4559

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as individual
Quality
83
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Partners of Northeast Florida LLC CurrentSince Apr 14, 2025 Accepting new patients
Physicians Group Services PA Family Past Accepting new patients
Family Care Partners of Northeast Florida LLC Past Accepting new patients

Locations

4565 US Highway 17
Ste 106
Fleming Isle, FL 32003
Phone (904) 269-4559

9550 Regency Square Blvd
Ste 300
Jacksonville, FL 32225
Phone (904) 744-7300

1215 Dunn Ave
Jacksonville, FL 32218
Phone (904) 757-1998

6484 Fort Caroline Rd
Jacksonville, FL 32277
Phone (904) 744-7300

14011 Beach Blvd
Ste 210220
Jacksonville Beach, FL 32250
Phone (904) 367-2277

425 W Colonial Dr
Ste 303
Orlando, FL 32804
Phone (321) 332-6947

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27472/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephania.dejno.1@27472.direct.athenahealth.com

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.

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": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1639636194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "833-702-8383",
            "fax_number": "689-304-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 US HIGHWAY 17 STE 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034822",
            "telephone_number": "904-269-4559",
            "fax_number": "904-269-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJNO",
        "first_name": "STEPHANIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105481400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.