Individual provider Active NPI

Kayla Stefanko, DO

  • Family Medicine Physician
  • Cadillac, MI
National Provider Identifier
1699201707
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022990 Issued in MI
Practice address
8950 Professional Dr
Cadillac, MI 49601-8599
Phone
(231) 876-1101
Fax
(231) 779-7701
NPI assigned
May 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101022990 MI Primary

Addresses

Primary practice location

8950 Professional Dr
Cadillac, MI 49601-8599

Mailing address

8950 Professional Dr
Cadillac, MI 49601-8599
Phone (231) 876-1101

Other practice location 1

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Other identifiers 1

IdentifierTypeStateIssuer
5101022990OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200903001005 MI Practitioner - Family Practice 1759708894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cadillac Family Physicians, P.C.Group PAC ID 2264405612, 8 clinicians

Practice addresses (Care Compare)

8950 Professional Dr
Cadillac, MI 49601-8599
Phone (231) 775-2493

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022990MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cadillac Family Physicians, P.C. CurrentSince Oct 1, 2020 Accepting new patients

Locations

8950 Professional Dr
Cadillac, MI 49601
Phone (231) 775-2493

Interoperability endpoints

  • Direct secure messaging: kaylastefanko@cfp.allscriptsdirect.net

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.

Hospital & facility affiliations 5

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": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1699201707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018599",
            "telephone_number": "231-876-1101",
            "fax_number": "231-775-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018599",
            "telephone_number": "231-876-1101",
            "fax_number": "231-779-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Medical Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847823",
            "country_code": "US",
            "telephone_number": "231-935-8000",
            "fax_number": "231-935-8099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFANKO",
        "first_name": "KAYLA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101022990",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.