Stephan Ambrose
NPI 1356047104ActiveIndividual· Physician Assistant· Miramar, FL
Physician Assistant in Miramar, Florida, licensed in FL and VA, with an NPI issued in February 2023. Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1356047104 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Feb 3, 2023 |
| Last updated in NPPES | Oct 9, 2025 |
| Certified by provider | Oct 9, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 9120439 | FL |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | 0110011203 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (VA) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Physician Assistant |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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