Individual provider Active NPI

Stephanie Harrison Hubbard, MD

  • Anesthesiology Physician
  • Muncie, IN
National Provider Identifier
1679558787
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01080270A Issued in IN
Practice address
2401 W University Ave
Muncie, IN 47303-3428
Phone
(765) 751-5404
NPI assigned
Dec 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0060671 MD
Anesthesiology Physician 207L00000X 01080270A IN Primary

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3428

Mailing address

1200 W White River Blvd
RCS Provider Enrollment
Muncie, IN 47303-4988
Phone (765) 254-4009

Other identifiers 1

IdentifierTypeStateIssuer
403262400MedicaidMD

Other names 1

  • Dr. Stephanie Harrison Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC, IN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080415000602 NY Practitioner - Anesthesiology 6507847423 Reassigns benefits to 1 organization
I20090309000325 DC Practitioner - Anesthesiology 6507847423 Reassigns benefits to 1 organization
I20190214000332 IN Practitioner - Anesthesiology 6507847423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Brody School of Medicine at East Carolina University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Anesthesia Services, P.C. 47 clinicians

Practice addresses (Care Compare)

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-6131

Hospital & facility affiliations

  • Nassau University Medical Center Hospital, East Meadow, NY, CCN 330027

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0060671MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Physicians, Inc. Anesthesiology CurrentSince Mar 1, 2019 Accepting new patients
Upstate Anesthesia Services, P.C. Anesthesiology CurrentSince Dec 12, 2023 Accepting new patients
North American Partners in Anesthesia Maryland LLC Anesthesiology PastSince Jul 10, 2022 Accepting new patients
Gwinnett Anesthesia Service PC Anesthesiology Past Accepting new patients
Anesthesia Healthcare Partners, Inc. Anesthesiology Past Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

Organizations & group practices 6

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": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1679558787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "address_2": "RCS PROVIDER ENROLLMENT",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "765-254-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-751-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "STEPHANIE HARRISON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-12",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0060671",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01080270A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403262400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HARRISON",
            "prefix": "DR.",
            "credential": "M. D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.