Individual provider Active NPI

Kristina Stefanac, M.D.

  • Psychiatry Physician
  • Chesterland, OH
National Provider Identifier
1760649396
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35098745 Issued in OH
Practice address
12804 Chillicothe Rd
Chesterland, OH 44026-9567
Phone
(216) 464-1277
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35098745 OH Primary

Addresses

Primary practice location

12804 Chillicothe Rd
Chesterland, OH 44026-9567

Mailing address

PO Box 35
Chesterland, OH 44026-0035
Phone (216) 464-1277

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35098745OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological and Psychiatric Consultants, LLC PastSince Aug 22, 2020 Accepting new patients
Advanced Therapy Center LTD Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1760649396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440260035",
            "telephone_number": "216-464-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12804 CHILLICOTHE RD",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440269567",
            "telephone_number": "216-464-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANAC",
        "first_name": "KRISTINA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35098745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.