Active NPI
Stacie B Peddy, M.D.
- Pediatric Critical Care Medicine Physician
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- ME167338
- Practice address
- 3100 SW 62ND Ave
Miami, FL 33155-3009 - Phone
- (305) 666-6511
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | MD426570 | PA | |
| Pediatrics Physician | 208000000X | MD426570 | PA | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | MD426570 | PA | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | D92544 | MD | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | ME167338 | FL | Primary |
Addresses
Primary practice location
3100 SW 62ND Ave
Miami, FL 33155-3009
Mailing address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone (305) 666-6511
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101470283 | Medicaid | PA | |
| 242289EMD | Other | PA | MEDICARE PTAN |
| 0092967 | Medicaid | NJ | |
| 659065900 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME167338 | FL | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Anesthesiology Associates, LTD | Pediatrics | Current | Accepting new patients |
| Children's Anesthesiology Associates, LTD | Pediatrics | Current | Accepting new patients |
| University of Maryland Pediatric Associates, PA | Pediatrics | Current | Accepting new patients |
| Children's Anesthesiology Associates, LTD | Current | Accepting new patients | |
| University of Maryland Pediatric Associates, PA | Pediatrics | Current | Accepting new patients |
Locations
22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
324 S 34th St
Ste 9329
Philadelphia, PA 19104
Phone (215) 590-1867
100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538
3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
Interoperability endpoints
- speddy847890@direct.umm.edu
Organizations & group practices 5
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.
-
dba CAA Anesthesiology Services
- Pediatric Anesthesiology Physician
- Philadelphia, PA
- NPI 1689779480
-
dba CAA Critical Care Services
- Pediatric Critical Care Medicine Physician
- Philadelphia, PA
- NPI 1497850291
Pediatrics
-
- Anesthesiology Physician
- Philadelphia, PA
- NPI 1942213525
Pediatrics
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Baltimore, MD
- NPI 1083933444
Pediatrics
-
- Pediatrics Physician
- Baltimore, MD
- NPI 1528163912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1700805090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-666-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-666-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDDY",
"first_name": "STACIE",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "PA",
"license": "MD426570",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD426570",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "PA",
"license": "MD426570",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MD",
"license": "D92544",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "FL",
"license": "ME167338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101470283",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "242289EMD",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0092967",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "659065900",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.