Active NPI
Stephan Robert Morey, PA
- Surgical Physician Assistant
- Modesto, CA
National Provider Identifier
1992000343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA12584
- Practice address
- 1421 Oakdale Rd
Modesto, CA 95355-3356 - Phone
- (209) 527-2700
- NPI assigned
- Jan 17, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA12584 | CA | Primary |
Addresses
Primary practice location
1421 Oakdale Rd
Modesto, CA 95355-3356
Mailing address
160 Bonita Cir
Modesto, CA 95354-1410
Phone (209) 499-9521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12584 | CA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295222400000",
"number": "1992000343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 BONITA CIR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541410",
"telephone_number": "209-499-9521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 OAKDALE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953553356",
"telephone_number": "209-527-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREY",
"first_name": "STEPHAN",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-17",
"last_updated": "2011-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA12584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.