MICHELLE M STEPHENS (APN) – Nurse Practitioner, NPI 1053764365

MICHELLE M STEPHENS (APN) is a healthcare provider. based in Roanoke, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 209-014570 (IL). The NPI Number for MICHELLE M STEPHENS (APN) is 1053764365

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE M STEPHENS (APN)
NPI
1053764365
Phone
(309) 923-2661
Address
401 N MAIN ST
Enumeration Date
21 July 2016
Last Update Date
21 July 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3099232661
Graduation Year
2016 (10 years ago)
PAC ID
7214221613
Group Practice PAC ID
0648187252
Professional Enrollment ID
I20160808002191
Address ID
IL615617585RO401XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MICHELLE M STEPHENS (APN)

  • 401 N MAIN ST

    ROANOKE, IL 615617585

    Phone: (309) 923-2661

    Fax: (309) 923-7628

    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: 2016-08-08

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
I20160808002191INurse PractitionerILTBD

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
36415Insertion of needle into vein for collection of blood sample203140$0
99214Established patient office or other outpatient visit, 30-39 minutes191140$0
99213Established patient office or other outpatient visit, 20-29 minutes182139$0
G0008Administration of influenza virus vaccine3131$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage2929$0
View full utilization report →

Insurance plans in this area (ZIP 61561)

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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: 0648187252View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL
Nurse PractitionerIL
-IL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL
Cardiovascular Disease (Cardiology), Internal MedicineIL

Reviews

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Frequently asked questions

What federal number belongs to MICHELLE M STEPHENS (APN)?
The federal identifier for MICHELLE M STEPHENS (APN) is NPI 1053764365.
Is MICHELLE M STEPHENS (APN)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MICHELLE M STEPHENS (APN) list a primary specialty?
If you are matching referrals, note Nurse Practitioner for MICHELLE M STEPHENS (APN). Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHELLE M STEPHENS (APN)?
The page summarizes Roanoke, Illinois for MICHELLE M STEPHENS (APN); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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