STEPHANIE ANN II GORHAM (MD) – Family Medicine Physician, NPI 1023239258
Family Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
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Provider Addresses for STEPHANIE ANN II GORHAM (MD)
PO BOX 78866
MILWAUKEE, WI 532788866
Phone: (779) 696-7150
Fax: (779) 696-7342
Type: Mailing
CORA Physical Therapy Belvidere, 1689, Henry Luckow Drive, Belvidere, Belvidere Township, Boone County, Illinois, 61008, United States
BELVIDERE, IL 61008
Phone: (779) 696-8650
Type: Location
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 $127.
Total Amount is formed as General ($127) + Research ($0) + Ownership ($0) = $127.
Last reported payment date: 2024-06-06 • Largest payer in this snapshot: Ethicon US, LLC ($127).
Total Amount
$127
General + Research + Ownership
Payments
1
Total payment records
General Amount
$127
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ethicon US, LLC | $127 |
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: 2009-11-04
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 |
|---|---|---|---|---|
| I20091104000153 | I | Family Practice | IL | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 461 | 253 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 313 | 172 | $0 |
| G0008 | Administration of influenza virus vaccine | 111 | 109 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 105 | 105 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 101 | 100 | $0 |
Insurance plans in this area (ZIP 53278)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IL | 90670 | Pneumococcal vaccine for injection into muscle | 66 | 66 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology), Internal Medicine | WI | |
| Thoracic Surgery, Cardiac Surgery | MI | |
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| General Surgery | GA | |
| Internal Medicine | WI | |
| N E U R O S U R G E R Y | IL | |
| - | WI | |
| Orthopedic Surgery | WI | |
| Physician Assistant | WI |
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