STEPHANIE TUCKER (AA) – Anesthesiologist Assistant, NPI 1104228154

STEPHANIE TUCKER (AA) is a healthcare provider. based in Savannah, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA. They hold a License No. 6370 (GA). The NPI Number for STEPHANIE TUCKER (AA) is 1104228154

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE TUCKER (AA)
NPI
1104228154
Phone
(912) 350-8977
Address
4700 WATERS AVE
Enumeration Date
22 September 2014
Last Update Date
27 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9123508000
Graduation Year
2014 (12 years ago)
PAC ID
2062739907
Group Practice PAC ID
8426466137
Professional Enrollment ID
I20150402000952
Address ID
GA314046220SA4700XAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

Provider Addresses for STEPHANIE TUCKER (AA)

  • 4700 WATERS AVE

    MEMORIAL HEALTH ANESTHETISTS

    SAVANNAH, GA 314046220

    Phone: (912) 350-8977

    Fax: (912) 350-7036

    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: 2015-04-02

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
I20150402000952IAnesthesiology AssistantGATBD

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 31404)

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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: 8426466137View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MO
Anesthesiology AssistantGA
Anesthesiology AssistantGA
A N E S T H E S I O L O G YGA
Anesthesiology AssistantFL
Anesthesiology AssistantGA
Anesthesiology AssistantGA
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)PA
A N E S T H E S I O L O G YGA

Reviews

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Frequently asked questions

What federal number belongs to STEPHANIE TUCKER (AA)?
The federal identifier for STEPHANIE TUCKER (AA) is NPI 1104228154.
Is STEPHANIE TUCKER (AA) currently active in the NPI registry?
CMS-published data lists STEPHANIE TUCKER (AA) as an active registrant.
What does STEPHANIE TUCKER (AA) treat or focus on?
Patients typically see STEPHANIE TUCKER (AA) under the specialty Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place STEPHANIE TUCKER (AA)?
The snapshot lists Savannah, Georgia for STEPHANIE TUCKER (AA); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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