Derrick Stephan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

33445 Paseo El Lazo
San Juan Capistrano, CA 92675-1003

Phone

(949) 338-3133

Fax

(949) 338-3133

NPI assigned

Jan 12, 2009

Sex

Male

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 CA

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Derrick Stephan, PA-C Inc.

  • Orthopaedic Surgery Physician
  • San Juan Capistrano, CA
  • NPI 1598234452
  NPD Authorized official
• Southern California Assistant Surgeons Inc.

  • Surgery Physician
  • San Juan Capistrano, CA
  • NPI 1528408556
  Medicare reassignment
• Trias Global, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Newport Beach, CA
  • NPI 1518433457
  NPD (past)

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

• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1891932950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33445 PASEO EL LAZO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751003",
            "telephone_number": "949-338-3133",
            "fax_number": "949-338-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33445 PASEO EL LAZO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751003",
            "telephone_number": "949-338-3133",
            "fax_number": "949-338-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "DERRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradford J. Staph, DDS
• Steven Stappaerts, MD
• Dianna Stark, LCSW
• Caroline Sue Statzula, RN
• Theresa Ann Steiner, MFTI
• Stephen J. Groth,MD,Inc
• Ruta Sternbergs
• Steven P. Theodosis Dental Corporation
• Jean Marie Stewart, MA PSYCHOLOGY C-4647
• Jillian Stewart, DPT

• Surgical Physician Assistant in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.