MRS. STEPHANIE ANN MACCONNEL (PA-C) – Physician Assistant, NPI 1407281496
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for MRS. STEPHANIE ANN MACCONNEL (PA-C)
5301 MCAULEY DR
YPSILANTI, MI 481971051
Phone: (734) 712-3456
Type: Mailing
1105 Sixth St
Traverse City, MI 496842345
Phone: (231) 935-6394
Type: Location
291 EDEN STREET
KINGSLEY, MI 49649
Phone: (734) 320-4417
Fax: (231) 392-2424
Type: Mailing
1105 SIXTH STREET
TRAVERSE CITY, MI 49684
Phone: (231) 392-0630
Fax: (231) 935-5885
Type: Location
1221 SIXTH ST STE 300
TRAVERSE CITY, MI 496842360
Phone: (231) 935-2400
Fax: (231) 392-2424
Type: Mailing
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: 2013-12-05
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 |
|---|---|---|---|---|
| I20131205001008 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48197)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| N E U R O S U R G E R Y | MI | |
| Internal Medicine | IL | |
| Family Practice | MI |
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