STEPHANIE ORTMAN (M.D.) – Dermatology Physician, NPI 1053679647

STEPHANIE ORTMAN (M.D.) is a healthcare provider. based in Jacksonville beach, Florida. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. ME117974 (FL). The NPI Number for STEPHANIE ORTMAN (M.D.) is 1053679647

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE ORTMAN (M.D.)
NPI
1053679647
Phone
(904) 249-6110
Address
3200 3RD ST S STE 200
Enumeration Date
2 May 2012
Last Update Date
3 August 2018

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9042798202
Graduation Year
2012 (14 years ago)
PAC ID
7416181706
Group Practice PAC ID
9830289818
Professional Enrollment ID
I20140908001122
Address ID
FL322163685JA8075XWXXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,369 DERMATOLOGY in FL

Provider Addresses for STEPHANIE ORTMAN (M.D.)

  • 3200 3RD ST S STE 200

    JACKSONVILLE BEACH, FL 322506097

    Phone: (904) 249-6110

    Fax: (904) 249-6119

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $161.

Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.

Last reported payment date: 2024-06-13 • Largest payer in this snapshot: Arcutis Biotherapeutics, Inc. ($44).

Total Amount

$161

General + Research + Ownership

Payments

7

Total payment records

General Amount

$161

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-13

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140908001122IDermatologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,240190$0
99213Established patient office or other outpatient visit, 20-29 minutes778488$0
17000Destruction of precancer skin growth, 1 growth367238$0
11102Biopsy of related skin growth, first growth198163$0
17110Destruction of skin growth, 1-14 growths183150$0
View full utilization report →

Insurance plans in this area (ZIP 32250)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830289818View full group profile
NameSpecialtyState
-FL
D E R M A T O L O G YFL
Physician AssistantFL
D E R M A T O L O G YFL

Reviews

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Frequently asked questions

How do payers reference STEPHANIE ORTMAN (M.D.)?
For STEPHANIE ORTMAN (M.D.), use NPI 1053679647 as the unique 10-digit identifier.
Is STEPHANIE ORTMAN (M.D.) shown as active in public data?
Registry records indicate STEPHANIE ORTMAN (M.D.) maintains an active NPI.
What expertise is attributed to STEPHANIE ORTMAN (M.D.)?
STEPHANIE ORTMAN (M.D.)'s specialty line reads Dermatology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with STEPHANIE ORTMAN (M.D.)?
Directory geography for STEPHANIE ORTMAN (M.D.) centers on Jacksonville Beach, Florida.
Does STEPHANIE ORTMAN (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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