DR. STANIA AYANNA DEJESUS (D.O) – Family Medicine Physician, NPI 1205097516
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,722 FAMILY PRACTICE in FL
Provider Addresses for DR. STANIA AYANNA DEJESUS (D.O)
1903 E FLETCHER AVE
TAMPA, FL 336123713
Phone: (813) 344-1084
Type: Location
447, Spruce Street, Walterboro, Colleton County, South Carolina, 29488, United States
WALTERBORO, SC 294882766
Phone: (843) 549-6331
Fax: (843) 549-6332
Type: Mailing
1903 E Fletcher Ave
Tampa, FL 336123713
Phone: (813) 344-1084
Type: Location
447 Spruce St
Walterboro, SC 294882766
Phone: (843) 549-6331
Fax: (843) 549-6332
Type: Location
1395 NW 167TH ST
MIAMI GARDENS, FL 331695710
Phone: (813) 344-1084
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2021-10-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150128002111 | I | Family Practice | SC | TBD |
| I20211012000538 | I | Family Practice | FL | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Internal Medicine, Geriatric Medicine | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | SD | |
| Family Practice | FL | |
| General Practice | FL | |
| - | IN |
Reviews
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