Stephanie Alysse Mason

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

67219 Issued in CT

Practice address

1817 Black Rock Tpke Ste 206
Fairfield, CT 06825-3546

Phone

(203) 337-5333

NPI assigned

Apr 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Black Rock Pediatrics

  • Pediatrics Physician
  • Fairfield, CT
  • NPI 1760629232
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1700240306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "973-971-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 BLACK ROCK TPKE STE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253546",
            "telephone_number": "203-337-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Blackford St",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374031405",
            "country_code": "US",
            "telephone_number": "423-778-6217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "STEPHANIE",
        "middle_name": "ALYSSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "67219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Martinez, M.ED
• Patricia M Martschenko, MSPT
• Thea R Marx, ND
• Mary Patricia Dunleavy Counseling Services, LLC
• Danielle Maryott
• Craig Massaro, R.PH
• Sara Massaro, SLP
• Christopher John Mastino, M.D.
• Melissa Mastroianni, M.D.
• Marina Mathew, PA-C

• Pediatrics Physician in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.