STEPHANIE ANNE DAVENPORT (PAC) – Physician Assistant, NPI 1003862186
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for STEPHANIE ANNE DAVENPORT (PAC)
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 480333849
Phone: (947) 522-1865
Fax: (947) 522-0307
Type: Mailing
44201 DEQUINDRE RD
TROY, MI 480851117
Phone: (248) 964-4866
Fax: (248) 964-4848
Type: Location
50505, Schoenherr Road, Shelby Charter Township, Macomb County, Michigan, 48315, United States
SUITE 290
SHELBY TOWNSHIP, MI 483153140
Phone: (586) 314-0054
Fax: (586) 731-6275
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $78.
Total Amount is formed as General ($78) + Research ($0) + Ownership ($0) = $78.
Last reported payment date: 2023-05-09 • Largest payer in this snapshot: Boston Scientific Corporation ($78).
Total Amount
$78
General + Research + Ownership
Payments
1
Total payment records
General Amount
$78
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $78 |
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: 2008-01-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080114000548 | I | Physician Assistant | MI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 48033)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Interventional Radiology, Diagnostic Radiology | MI | |
| - | MI | |
| - | MI | |
| Family Practice | MI | |
| - | MI | |
| P A T H O L O G Y | MI | |
| - | MI | |
| Emergency Medicine | CA | |
| - | MI |
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