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

Stephanie Locicero, PA-C

Individual provider Internal Medicine Physician · NPI 1659937456

Stephanie Locicero, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2019, 7 years ago. Practices with University Professional Services, a 1,704-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and Oregon.

Years since qualifying
7
Licensed in
NY, OR
In the registry since
2019
Specialties on file
3
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

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-6594
Fax: (503) 494-4285
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 Elmwood Ave, Rochester, NY 14642-1603 — (585) 275-0526

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA213429 (OR)
Internal Medicine Physician Taxonomy 207R00000X · Licence 23973 (NY)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1659937456
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 16, 2019
Last updated in NPPESJuly 17, 2023
Certification dateMay 11, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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