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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

STANLEY DINGBOBGA FOMBAN APRN
NPI 1639890908
Nurse Practitioner - Family in Lutz, FL

Active since September 06, 2022PECOS Enrolled
4211 VAN DYKE RD STE 200, LUTZ, FL 33558(813) 321-6237(813) 463-1801 Get Directions Write a Review

NPPES record last updated: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2026, Aug 4, 2024, Feb 6, 2023 and 1 more (4 updates tracked since 2022).

About Stanley Dingbobga Fomban Aprn NPPES

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

STANLEY DINGBOBGA FOMBAN APRN (NPI 1639890908) is an individual family provider in Lutz, Florida, licensed in Florida (APRN11021138) and active in the NPI registry since September 2022. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1639890908
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameSTANLEY DINGBOBGA FOMBANCredential: APRN
Location Address4211 VAN DYKE RD STE 200Lutz, FL 33558-8005
Mailing Address2995 Drew St Fl 2Clearwater, FL 33759-3012 · (727) 532-0002
Phone(813) 321-6237
Fax(813) 463-1801
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 6, 2022
Last NPPES UpdateAugust 3, 20264 updates tracked since enumeration
NPPES CertifiedAugust 3, 2026
✔ NPI 1639890908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · APRN11021138
4211 VAN DYKE RD STE 200, Lutz, FL 33558
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stanley Dingbobga Fomban Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537538988
PECOS Enrollment IDI20221207002334
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Josephs Hospital

Acute Care Hospitals · Tampa, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100075
Location3001 W Martin Luther King Jr BlvdTampa, FL 33677 · Hillsborough County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33558 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 20

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

JASMINE YOUNG
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
TAHIR HUSSAIN RIZVI MD
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
DR. JAMES TERENCE FARRELL DO
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
PAVEL CAPOTE MD
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
DR. SAI C ORUGANTI M.D.
Internal Medicine
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
BAYCARE MEDICAL GROUP INC
Internal Medicine (Hematology & Oncology)
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 264-6490
IDLJONA GLLAVA M.D.
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237
DR. ROBERT F. KOCH D.O.
Hospitalist
4211 VAN DYKE RD STE 200
LUTZ, FL 33558
Hillsborough County (813) 321-6237

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 Stanley Fomban's NPI number?

The NPI number for Stanley Fomban is 1639890908. It was assigned to this individual provider in the NPPES registry on September 6, 2022.

Where is Stanley Fomban located?

Stanley Fomban practices at 4211 Van Dyke Rd Ste 200, Lutz, FL 33558. The listed phone number is (813) 321-6237.

What is Stanley Fomban's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Stanley Fomban enrolled in Medicare?

Yes. Stanley Fomban is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Stanley Fomban accept?

Health plans from AvMed list Stanley Fomban 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.

Is Stanley Fomban affiliated with any hospitals?

According to CMS data, Stanley Fomban is affiliated with St Josephs Hospital.

When was this NPI record last updated?

The NPPES record for Stanley Fomban was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.