Individual provider Active NPI

Stephanie W Conn, P.A.C.

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1821226754
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA030914 Issued in DC
Practice address
1627 Eye St NW
Suite 800
Washington, DC 20006-4007
Phone
(202) 660-0025
Fax
(202) 660-0015
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9105004 FL
Medical Physician Assistant 363AM0700X PA030914 DC Primary

Addresses

Primary practice location

1627 Eye St NW
Suite 800
Washington, DC 20006-4007

Mailing address

130 Sutter St 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Other identifiers 1

IdentifierTypeStateIssuer
PA 9105004OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20160906000288 DC Practitioner - Physician Assistant 8921294190 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiocare LLCGroup PAC ID 1254332729, 16 clinicians

Practice addresses (Care Compare)

5530 Wisconsin Ave
Suite 700
Chevy Chase, MD 20815-4401
Phone (301) 656-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA030914DCMDMedical Physician Assistant
PA 9105004FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
District Hospital Partners LP CurrentSince Mar 31, 2019 Accepting new patients
District Hospital Partners L P CurrentSince Mar 31, 2019 Accepting new patients
Maryland Inpatient Care Specialists LLC Past Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

Interoperability endpoints

  • Direct secure messaging: sconn1129720@direct.hopkinsmedicine.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1821226754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 EYE ST NW",
            "address_2": "SUITE 800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200064007",
            "telephone_number": "202-660-0025",
            "fax_number": "202-660-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "STEPHANIE",
        "middle_name": "W",
        "name_prefix": "Miss",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9105004",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA 9105004",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.