Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kseniya Stockhammer, PA-C

Individual provider Physician Assistant · NPI 1588230767

Kseniya Stockhammer, PA-C is a Physician Assistant in Palm Coast, Florida. Qualified in 2021, 5 years ago. Practices with Parks Dermatology Center LLC, a 17-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

37 Old Kings Rd
Palm Coast, FL 32137-8227
Phone: (386) 677-9044
Fax: (386) 677-3083
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 33 Old Kings Rd N, Palm Coast, FL 32137-8238 — (386) 677-9044

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1588230767
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 28, 2021
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Parks Dermatology Center Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Palm Coast