DR. MARK A STEFANELLI (NPI# 1366486912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366486912 |
| Entity Type | Individual |
| Full Name | DR. MARK A STEFANELLI |
| Credential | M.D. |
| Practice Address |
2647 Grand Ave Astoria OR 97103-3329 |
| Mailing Address |
2647 Grand Ave Astoria OR 97103-2915 |
| Practice Telephone | 5037396164 |
| Mailing Telephone | 5037396164 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MD19990 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OMAP | 130263 | 01 |
| Street Address |
2647 GRAND AVE |
| City | ASTORIA |
| State | OR |
| Zip Code | 97103-3329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730552845 | Kpg Oregon, LLC | Internal Medicine | 486 12th Street #200, Astoria, OR 97103 | 2015-11-11 |
| 1205239043 | Brittany Dawn Vigoren | Dental Hygienist | 433 30th St., Astoria, OR 97103 | 2014-10-08 |
| 1497188858 | Jennifer U Boggs | Counselor | 10 Pier 1 Ste 203, Astoria, OR 97103 | 2013-08-20 |
| 1780022046 | Judy J Curnow | Massage Therapist | 1 12th Street Suite 10, Astoria, OR 97103 | 2013-06-10 |
| 1659626612 | Megan Lampson | Physical Therapist | 646 16th Ave., Astoria, OR 97103 | 2012-07-16 |
| 1043580947 | Matthew Thomas Cassity | Physical Therapy Assistant | 646 16th St., Astoria, OR 97103 | 2012-01-09 |
| 1881975969 | Rebecca Nicole Roe | Contractor | 25 Whitebush Way, Astoria, OR 97103 | 2011-09-02 |
| 1346542214 | Michele Lynn Hart | Social Worker | 2120 Exchange, Astoria, OR 97103 | 2010-11-29 |
| 1447551197 | Barbara Ellen Arnold | Pharmacist | 3250 Leif Erickson Dr, Astoria, OR 97103 | 2010-11-11 |
| 1083915219 | Christina Louise Jones | Pharmacist | 3250 Lief Erickson Dr, Astoria, OR 97103 | 2010-11-04 |
| Find all providers in zip 97103 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139418 | Larry Michael Wiedenhoft | Emergency Medicine | 465 Manzanita Ave, Manzanita, OR 97130-0810 | 2020-03-17 |
| 1184829244 | Se Jung Shin Md Professional Corporation | Emergency Medicine | 13305 Nw Cornell Road, Suite C, Portland, OR 97229 | 2007-06-19 |
| 1104028059 | Annameika Eve Goldring | Emergency Medicine | 3181 S.w. Sam Jackson Park Rd., Portland, OR 97239 | 2007-06-04 |
| 1053467985 | Brian Murray Auld | Emergency Medicine | 3621 Elderberry Dr S, Salem, OR 97302-4054 | 2007-01-25 |
| 1750448981 | Carl M Melina | Emergency Medicine | 18610 Nw Cornell Road, Suite 100, Hillsboro, OR 97124-9923 | 2007-01-03 |
| 1023103546 | Michael F. Mccaskill | Emergency Medicine | 436 Timber Lane, Grants Pass, OR 97526 | 2006-10-03 |
| 1801845953 | David Ernest Magaret | Emergency Medicine | 1201 Ne Elm St, Prineville, OR 97754-1206 | 2006-05-08 |
| 1649235219 | Victoria V Harris | Emergency Medicine | 100 E. Main Street, Suite C, Medford, OR 97501-6041 | 2006-04-18 |
| 1003870536 | Brad Barlow | Emergency Medicine | 351 Sw 9th St, Ontario, OR 97914-2639 | 2006-04-13 |
| 1285602086 | Erin P Reilly | Emergency Medicine | 860 Beltline Rd, Springfield, OR 97477-1091 | 2006-03-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.