STACY A MCCONKEY (MD) – Pediatrics Physician, NPI 1710972492

STACY A MCCONKEY (MD) is a healthcare provider. based in Winter garden, Florida. specializing in Pediatrics Physician. They hold the professional credentials MD. They hold a License No. ME 113754 (FL). The NPI Number for STACY A MCCONKEY (MD) is 1710972492

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
STACY A MCCONKEY (MD)
NPI
1710972492
Phone
(407) 656-0042
Address
15502 STONEYBROOK WEST PKWY
Enumeration Date
19 September 2005
Last Update Date
29 July 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4073035600
Graduation Year
1994 (32 years ago)
PAC ID
3072769629
Group Practice PAC ID
0749186153
Professional Enrollment ID
I20120814000321
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for STACY A MCCONKEY (MD)

  • Publix, 15502, Stoneybrook West Parkway, Harlem Heights, Winter Garden, Orange County, Florida, 34787, United States

    SUITE 2-108

    WINTER GARDEN, FL 347874767

    Phone: (407) 656-0042

    Fax: (407) 656-0663

    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)

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: 2012-08-14

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
I20120814000321IPediatric MedicineFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34787)

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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: 0749186153View full group profile
NameSpecialtyState
Physician AssistantFL
N E U R O L O G YFL
General SurgeryFL
Cardiovascular Disease (Cardiology), Internal Medicine, Interventional CardiologyFL
Nurse PractitionerFL
O B S T E T R I C S/ G Y N E C O L O G YFL
General SurgeryFL
Pulmonary Disease, Critical Care (Intensivists)FL
O B S T E T R I C S/ G Y N E C O L O G YMI
Physician AssistantFL

Reviews

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Frequently asked questions

What NPI should I save for STACY A MCCONKEY (MD)?
Save NPI 1710972492 if you need a stable reference for STACY A MCCONKEY (MD).
Is STACY A MCCONKEY (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does STACY A MCCONKEY (MD) list a primary specialty?
If you are matching referrals, note Pediatrics Physician for STACY A MCCONKEY (MD). Clinical services aligned with this taxonomy classification.
Does STACY A MCCONKEY (MD) practice in Florida?
You will see Winter Garden, Florida on file for STACY A MCCONKEY (MD) alongside any extra practice locations.
What if Winter Garden, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.