Stephanie Ayita Knuppenburg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME150156 Issued in FL

Practice address

4700 N Congress Ave Ste 103
West Palm Beach, FL 33407-3284

Phone

(561) 622-6111

Fax

(855) 215-9930

NPI assigned

Jun 18, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Stephanie Avita Jugmohan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 25, 2024 through Apr 25, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• The Medical Group of South Florida Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1700176013

  Multi-Specialty

  NPD (past)
• The Medical Group of South Florida, Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1023454063

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1962816876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "552-159-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE STE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073284",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1094 Military Trl",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334587021",
            "country_code": "US",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUPPENBURG",
        "first_name": "STEPHANIE",
        "middle_name": "AYITA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301105575",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "54346",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301105575",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME150156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "JUGMOHAN",
            "middle_name": "AVITA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Kniseley, MS CCC, SLP
• Ozanne Knoop, LCSW
• Knowledge Is Power Charitable Foundation
• Kirsten Jo Knowles, O.D.
• Kort Christopher Knudson, MD
• Iris Ko, PA-C
• Susan McBride Koff, A.R.N.P.
• Alan Norman Kohn, M.D.
• Caryl Kohn, LMT
• Philip Stuart Kohn, D.D.S.

• Family Medicine Physician in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.