Stephanie Ina Mary Struble, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1951 Pine Hall Road Suite 225
State College, PA 16801-5106

Phone

(814) 237-0001

Fax

(814) 237-0001

NPI assigned

Jun 7, 2017

Last updated

Sep 7, 2021By the provider in NPPES

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

Other names 1

• Stephanie Ina Mary Walizer Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Willow Wellness PCGroup PAC ID 5597271577, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Silver Willow Wellness PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Reading, PA
  • NPI 1659164697
  Medicare reassignment Care Compare group NPD
• Oasis Lifecare LLC

  • Psychiatry Physician
  • State College, PA
  • NPI 1013398130
  Medicare reassignment
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957
  Medicare reassignment

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1710416300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 PINE HALL ROAD SUITE 225",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015106",
            "telephone_number": "814-237-0001",
            "fax_number": "814-237-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 PINE HALL ROAD SUITE 225",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015106",
            "telephone_number": "814-237-0001",
            "fax_number": "814-237-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUBLE",
        "first_name": "STEPHANIE",
        "middle_name": "INA MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WALIZER",
            "middle_name": "INA MARY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell Straub
• Austin Straw, PT, DPT
• Strawberry Fields, Inc
• Kimberly Strickland, ARNP
• Gary Stroschein
• Richard Allen Stuart, DED
• Heather Darby Stube, LCSW
• Lauren Sullivan
• Leslie H Sullivan, MS, NCC
• Scott A. Sulman, D.O.

• Physician Assistant in State College, PA
• Providers in State College, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.