MRS. STACEY LYNNE EVANS-PAULIN (PA-C) – Medical Physician Assistant, NPI 1851646467

Medical Physician Assistant

MRS. STACEY LYNNE EVANS-PAULIN (PA-C) is a healthcare provider. based in Brookhaven, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 034197 (NY). The NPI Number for MRS. STACEY LYNNE EVANS-PAULIN (PA-C) is 1851646467

Main info

Female

Sole Proprietor

14 Years Of Experience

Accepts Medicare Assignment

Name

MRS. STACEY LYNNE EVANS-PAULIN (PA-C)

NPI

1851646467

Phone

Not provided

Address

1203 OGLETHORPE DR NE

Enumeration Date

19 July 2012

Last Update Date

5 February 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7702228900

Graduation Year

2012 (14 years ago)

PAC ID

9739338807

Group Practice PAC ID

3274559323

Professional Enrollment ID

I20121004000488

Address ID

GA301412804HI3827XPKWY500

Telehealth

Yes

Contacts

SOAP Endpoint

https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience59

Completeness95

Years active:13State licenses:2Other names

13,243 PHYSICIAN ASSISTANT in NY

Provider Addresses for MRS. STACEY LYNNE EVANS-PAULIN (PA-C)

1203 OGLETHORPE DR NE
BROOKHAVEN, GA 303192784
Phone:
Type: Mailing
1295 Broadway
Brooklyn, NY 112212973
Phone: (718) 682-3903
Fax: (718) 682-3904
Type: Location
1362 S MAIN ST
ELLIJAY, GA 305405410
Phone: (706) 276-4741
Type: Location

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: 2025-09-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

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
I20121004000488	I	Physician Assistant	GA	TBD
I20250527001664	I	Physician Assistant	CT	TBD
I20250926001086	I	Physician Assistant	NY	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.

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 30319)

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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: 3274559323View full group profile

Name	Specialty	State
MICHAEL C. MARTIN (PA-C)	Physician Assistant	GA
PAUL DAVID GROOVER (NP-C)	Nurse Practitioner	GA
NOTOYA SCOTT (NP-C)	Nurse Practitioner	GA
ANGELA DEAN HAMILTON	Nurse Practitioner	GA
RACHEL WARBURTON (NP-C)	Nurse Practitioner	GA
DOROTHY BRE'ANNA D THOMAS (FNP-C)	Nurse Practitioner	GA
DR. THOMAS J FEDERICO (MD)	Family Practice, Physical Medicine And Rehabilitation	GA
MELANIE RAMSEY	Nurse Practitioner	GA
MR. TIMOTHY CHARLES CASTELLAW (PA-C)	-	GA
UPASNA SHARMA (NP)	-	GA

Reviews

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Frequently asked questions

Can I cross-check MRS. STACEY LYNNE EVANS-PAULIN (PA-C) using NPI 1851646467?

NPI 1851646467 belongs to MRS. STACEY LYNNE EVANS-PAULIN (PA-C); compare other details if you need extra assurance.

Active or inactive — what applies to MRS. STACEY LYNNE EVANS-PAULIN (PA-C)?

You should see MRS. STACEY LYNNE EVANS-PAULIN (PA-C) as active in CMS-hosted NPPES data.

What kind of doctor is MRS. STACEY LYNNE EVANS-PAULIN (PA-C)?

MRS. STACEY LYNNE EVANS-PAULIN (PA-C) is associated with Medical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.

Is MRS. STACEY LYNNE EVANS-PAULIN (PA-C) located near Brookhaven?

MRS. STACEY LYNNE EVANS-PAULIN (PA-C) currently maps to Brookhaven, Georgia in this extract.

Can I trust this NPI listing for MRS. STACEY LYNNE EVANS-PAULIN (PA-C)?

The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.