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

Mary Rebecca Stoll, PA

Individual provider Physician Assistant · NPI 1083862098

Mary Rebecca Stoll, PA is a Physician Assistant in Petoskey, Michigan. Qualified in 2008, 18 years ago. Practices with Advanced Dermatology of Michigan PC, a 40-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
18
Licensed in
MI
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

4170 Cedar Bluff Dr
Petoskey, MI 49770-7627
Phone: (231) 487-2230
Fax: (231) 487-6172
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence L1397712 (MI)

Record details

NPI number1083862098
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 3, 2008
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Advanced Dermatology Of Michigan Pc — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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