Individual provider Active NPI

Stephanie J Herald, CAA

  • Anesthesiologist Assistant
  • Gary, IN
National Provider Identifier
1891343174
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000045A Issued in IN
Practice address
600 Grant St
Gary, IN 46402-6001
Phone
(219) 886-4000
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000045A IN Primary

Addresses

Primary practice location

600 Grant St
Gary, IN 46402-6001

Mailing address

512 W Wrightwood Ave Apt 2B
Chicago, IL 60614-4930

Other practice location 1

8701 Broadway
Merrillville, IN 46410-7035
Phone (219) 738-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190925001557 IN Practitioner - Anesthesiology Assistant 4183954712 Reassigns benefits to 1 organization
I20240903000937 MI Practitioner - Anesthesiology Assistant 4183954712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

4800 S Saginaw St
Flint, MI 48507-2677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
75000045AINMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Porter County Anesthesia Associates PC CurrentSince Dec 28, 2020 Accepting new patients
Jawad a Shah, MD PC CurrentSince Aug 26, 2024 Accepting new patients
Jawad a Shah MD PC CurrentSince Aug 26, 2024 Accepting new patients
Alliance Anesthesia PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

Organizations & group practices 4

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 1

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": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1891343174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W WRIGHTWOOD AVE APT 2B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026001",
            "telephone_number": "219-886-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 Broadway",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107035",
            "country_code": "US",
            "telephone_number": "219-738-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERALD",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000045A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.