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STEPHANIE PHAN DO
NPI 1639664717
Pediatrics in Davenport, FL

Active since June 29, 2018PECOS Enrolled
410 LIONEL WAY FL 3, DAVENPORT, FL 33837(863) 293-1191(863) 837-5333 Get Directions Write a Review

NPPES record last updated: March 2, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 2, 2026, Sep 23, 2024, Jun 11, 2019 and 1 more (4 updates tracked since 2018).

About Stephanie Phan Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHANIE PHAN DO (NPI 1639664717) is an individual pediatrics provider in Davenport, Florida, licensed in Florida (OS17951) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1639664717
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSTEPHANIE PHANCredential: DO
Location Address410 LIONEL WAY FL 3Davenport, FL 33837-7809
Mailing Address500 E Central AveWinter Haven, FL 33880-3094 · (863) 293-1191 · Fax (863) 837-5333
Phone(863) 293-1191
Fax(863) 837-5333
Sole ProprietorYes
Enumeration DateJune 29, 2018
Last NPPES UpdateMarch 2, 20264 updates tracked since enumeration
NPPES CertifiedMarch 2, 2026
✔ NPI 1639664717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · OS17951
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
410 LIONEL WAY FL 3, Davenport, FL 33837
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Secondary Practice Location 1

Location 16484 Fort Caroline RdJacksonville, FL 32277-2042 · Phone (904) 659-4735

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Cigna Healthcare, Cigna HealthCare of Florida, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie Phan Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Stephanie Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bond Clinic PA
12 mi
Internal Medicine
500 E CENTRAL AVE
Winter Haven, FL 33880
  • Reassigned Medicare billing, Florida enrollment
  • 120 clinicians in this Medicare group
NPI 1881639193 (863) 293-1191

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33837 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SENDY MORA
Nurse Practitioner
410 LIONEL WAY FL 3
DAVENPORT, FL 33837
Polk County (863) 419-2429
DR. ANDREW MICHAEL TEFFEAU D.O.
Family Medicine
410 LIONEL WAY FL 3
DAVENPORT, FL 33837
Polk County (863) 293-1191
DR. ARMANDO ANTONIO DOVAL M.D.
Internal Medicine
410 LIONEL WAY FL 3
DAVENPORT, FL 33837
Polk County (863) 293-1191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephanie Phan's NPI number?

The NPI number for Stephanie Phan is 1639664717. It was assigned to this individual provider in the NPPES registry on June 29, 2018.

Where is Stephanie Phan located?

Stephanie Phan practices at 410 Lionel Way Fl 3, Davenport, FL 33837. The listed phone number is (863) 293-1191.

What is Stephanie Phan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Stephanie Phan enrolled in Medicare?

Yes. Stephanie Phan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Stephanie Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Phan reassigns Medicare benefits to Bond Clinic PA (Winter Haven, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephanie Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stephanie Phan accept?

Health plans from AvMed, Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Stephanie Phan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stephanie Phan was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.