Stephanie Rae Dastrup, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1181 Issued in NV

Practice address

2880 N Tenaya Way Ste 420
Las Vegas, NV 89128-0642

Phone

(702) 255-2022

Fax

(702) 255-8810

NPI assigned

Sep 29, 2009

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

Enrolled in NV

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Women'S Health Associates of Southern Nevada- Martin, PLLCGroup PAC ID 4082845664, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.dastrup@whasn.eclinicaldirectplus.com

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.

• Women'S Health Associates of Southern Nevada- Martin, PLLC

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
  • NPI 1598906166
  Medicare reassignment Care Compare group NPD
• Desert Springs Hospital

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1154317964
  NPD (past)

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1760716419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 SPANISH RIDGE AVE STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481319",
            "telephone_number": "702-330-3102",
            "fax_number": "702-912-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 N TENAYA WAY STE 420",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280642",
            "telephone_number": "702-255-2022",
            "fax_number": "702-255-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASTRUP",
        "first_name": "STEPHANIE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Junaid Dastagir
• Rabiha Dastgir
• Amber R Dastrup
• Anthony Dastrup I
• Carrie Dastrup, BA LSW
• Geeline Datuin
• Rhina Noemy Daubert
• Suzanne Marie Daubney
• Michael D Daubs, MD
• Dorthia S Daudier, RN

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.