Individual provider Active NPI

Stephanie R Bennett, PA-C

  • Medical Physician Assistant
  • Winter Haven, FL
National Provider Identifier
1992999270
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105981 Issued in FL
Practice address
5999 Dundee Rd
Suite 750
Winter Haven, FL 33884-1107
Phone
(863) 292-4077
Fax
(863) 292-4079
NPI assigned
Aug 30, 2007
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105981 FL Primary

Addresses

Primary practice location

5999 Dundee Rd
Suite 750
Winter Haven, FL 33884-1107

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other names 1

  • Stephanie R Melwani 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000679 FL Practitioner - Physician Assistant 9436230539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

10000 W Colonial Dr
Ocoee, FL 34761-3400
Phone (407) 578-0033

17000 Porter Rd
Winter Garden, FL 34787-8915

32 W Gore St
Orlando, FL 32806-1134

9400 Turkey Lake Rd
Orlando, FL 32819-8001
Phone (407) 354-1202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Nov 8, 2017 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Nov 8, 2017 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

7301 Stonerock Cir
Orlando, FL 32819
Phone (407) 345-0005

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sbennett31029@orlandohealth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1992999270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5999 DUNDEE RD",
            "address_2": "SUITE 750",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841107",
            "telephone_number": "863-292-4077",
            "fax_number": "863-292-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MELWANI",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.