Individual provider Active NPI

Stefanie M Vallancourt, DO

  • Anesthesiology Physician
  • Daytona Beach, FL
National Provider Identifier
1881033561
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS14474 Issued in FL
Practice address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone
(386) 254-4226
Fax
(352) 265-6922
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X UO3620 FL
Anesthesiology Physician 207L00000X OS14474 FL Primary

Addresses

Primary practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Mailing address

1329 SW 16TH St RM 2232
Gainesville, FL 32608-1128
Phone (352) 733-0485

Other names 1

  • Stefanie M Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114000665 FL Practitioner - Anesthesiology 8123254240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

1 Adventhealth Way
Palm Coast, FL 32137-4702
Phone (386) 302-1800

1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 253-3333

401 Palmetto St
New Smyrna Beach, FL 32168-7322
Phone (386) 424-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2025

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Mar 12, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 1, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 1, 2020 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

541 Health Blvd
Daytona Beach, FL 32114
Phone (386) 239-0021

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

401 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-5000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

300 Clyde Morris Blvd
Ste B
Ormond Beach, FL 32174
Phone (386) 672-1080

345 Clyde Morris Blvd
Ste 300
Ormond Beach, FL 32174
Phone (386) 672-7575

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Interoperability endpoints

  • Direct secure messaging: svallancourt76424@direct.shands.ufl.edu

Organizations & group practices 3

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": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1881033561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 SW 16TH ST RM 2232",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081128",
            "telephone_number": "352-733-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-254-4226",
            "fax_number": "352-265-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLANCOURT",
        "first_name": "STEFANIE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "UO3620",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS14474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.