Individual provider Active NPI

Stephanie Taraneh Jazayri-Billie, P.A.-C

  • Medical Physician Assistant
  • Homestead, FL
National Provider Identifier
1649419565
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9104819 Issued in FL
Practice address
925 NE 30TH Ter Ste 308
Homestead, FL 33033-7614
Phone
(941) 926-6553
Fax
(941) 296-8501
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9104819 FL Primary

Addresses

Primary practice location

925 NE 30TH Ter Ste 308
Homestead, FL 33033-7614

Mailing address

4411 Bee Ridge Rd,
PMB 309
Sarasota, FL 34233-2514
Phone (941) 234-6388

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9104819FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Knock Your Socks Off Foot & Ankle Specialist LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1649419565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 BEE RIDGE RD,",
            "address_2": "PMB 309",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332514",
            "telephone_number": "941-234-6388",
            "fax_number": "941-926-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 NE 30TH TER STE 308",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337614",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZAYRI-BILLIE",
        "first_name": "STEPHANIE",
        "middle_name": "TARANEH",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9104819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.