STEFANI BISSONETTE (MD) – Obstetrics & Gynecology Physician, NPI 1407200660

STEFANI BISSONETTE (MD) is a healthcare provider. based in Douglas, Wyoming. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 13011A (WY). The NPI Number for STEFANI BISSONETTE (MD) is 1407200660

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
STEFANI BISSONETTE (MD)
NPI
1407200660
Phone
(307) 358-7300
Address
700 E CENTER ST
Enumeration Date
14 April 2016
Last Update Date
22 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
3076826263
Graduation Year
2016 (10 years ago)
PAC ID
8527350495
Group Practice PAC ID
6608162029
Professional Enrollment ID
I20200805000423
Address ID
WY827163328GI1414XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

183 OBSTETRICS/GYNECOLOGY in DE

Provider Addresses for STEFANI BISSONETTE (MD)

  • 700 E CENTER ST

    DOUGLAS, WY 826332446

    Phone: (307) 358-7300

    Type: Mailing

  • 4755 OGLETOWN STANTON RD

    NEWARK, DE 197182200

    Phone:

    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: 2020-08-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200805000423IObstetrics/GynecologyWYTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 82633)

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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: 6608162029View full group profile
NameSpecialtyState
Nurse PractitionerWY
O B S T E T R I C S/ G Y N E C O L O G YWY
Nurse PractitionerWY

Reviews

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Frequently asked questions

What is STEFANI BISSONETTE (MD)'s NPI number?
STEFANI BISSONETTE (MD)'s NPI is 1407200660 — the number used across U.S. healthcare to identify this provider.
Would STEFANI BISSONETTE (MD) appear as active to a payer?
You can treat STEFANI BISSONETTE (MD) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is STEFANI BISSONETTE (MD)?
STEFANI BISSONETTE (MD) is associated with Obstetrics & Gynecology Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Wyoming is STEFANI BISSONETTE (MD) registered?
Use Douglas, Wyoming as the headline location for STEFANI BISSONETTE (MD) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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