Individual provider Active NPI

Stephanie Pawlikowski-Platt, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1750588786
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9104183 Issued in FL
Practice address
7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411
Phone
(619) 325-1161
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9104183 FL Primary

Addresses

Primary practice location

7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411

Mailing address

7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411
Phone (619) 325-1161

Other identifiers 1

IdentifierTypeStateIssuer
1750588786OtherFLNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
21779CAMDPhysical Therapist
PA 9104183FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Care LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1750588786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR",
            "address_2": "SUITE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084411",
            "telephone_number": "619-325-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR",
            "address_2": "SUITE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084411",
            "telephone_number": "619-325-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLIKOWSKI-PLATT",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9104183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750588786",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.