MARY REBECCA STOLL (P.A.) – Physician Assistant, NPI 1083862098

MARY REBECCA STOLL (P.A.) is a healthcare provider. based in Williamsburg, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. L1397712 (MI). The NPI Number for MARY REBECCA STOLL (P.A.) is 1083862098

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
MARY REBECCA STOLL (P.A.)
NPI
1083862098
Phone
(231) 938-7004
Address
3950 SHORE DR
Enumeration Date
3 September 2008
Last Update Date
8 November 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2314872230
Graduation Year
2008 (18 years ago)
PAC ID
6800957937
Group Practice PAC ID
0941511224
Professional Enrollment ID
I20081209000151
Address ID
MI497707627PE4170XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

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Provider Addresses for MARY REBECCA STOLL (P.A.)

  • 3950, Shore Drive, Williams Heights, Two Johns Estates, Caroline County, Maryland, 21655, United States

    WILLIAMSBURG, MI 496909548

    Phone: (231) 938-7004

    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)

CMS reports 76 Open Payments records for all available years, with a total value of $1,222.

Total Amount is formed as General ($1,222) + Research ($0) + Ownership ($0) = $1,222.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($351).

Total Amount

$1,222

General + Research + Ownership

Payments

76

Total payment records

General Amount

$1,222

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2008-12-09

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
I20081209000151IPhysician AssistantMITBD

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
17003Destruction of precancer skin growth, 2-14 growths1,084230$0
99213Established patient office or other outpatient visit, 20-29 minutes1,061876$0
17000Destruction of precancer skin growth, 1 growth382338$0
11102Biopsy of related skin growth, first growth232203$0
17110Destruction of skin growth, 1-14 growths198176$0
View full utilization report →

Insurance plans in this area (ZIP 49690)

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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: 0941511224View full group profile
NameSpecialtyState
Physician AssistantMI
Nurse PractitionerMI
-MI
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
Dermatology, Micrographic Dermatologic Surgery (Mds)MI
Emergency MedicineMI
D E R M A T O L O G YMI
Physician AssistantIN

Reviews

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Frequently asked questions

What NPI should I save for MARY REBECCA STOLL (P.A.)?
Save NPI 1083862098 if you need a stable reference for MARY REBECCA STOLL (P.A.).
Does this profile mean MARY REBECCA STOLL (P.A.) is currently active?
Yes — MARY REBECCA STOLL (P.A.) appears active in the national provider directory.
Does MARY REBECCA STOLL (P.A.) list a primary specialty?
If you are matching referrals, note Physician Assistant for MARY REBECCA STOLL (P.A.). Clinical services aligned with this taxonomy classification.
Does MARY REBECCA STOLL (P.A.) practice in Michigan?
You will see Williamsburg, Michigan on file for MARY REBECCA STOLL (P.A.) alongside any extra practice locations.
How can I contact MARY REBECCA STOLL (P.A.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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