NPIMap

Individual provider Active NPI

Charles Raymond Stevens, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • El Centro, CA
National Provider Identifier
1003001363
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A104563 Issued in CA
Practice address
1665 S Imperial Ave Ste D
El Centro, CA 92243-4247
Phone
(760) 482-0212
Fax
(760) 482-0166
NPI assigned
Sep 10, 2007
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X A104563 CA Primary

Addresses

Primary practice location

1665 S Imperial Ave Ste D
El Centro, CA 92243-4247

Mailing address

1665 S Imperial Ave Ste D
El Centro, CA 92243-4247
Phone (760) 482-0212

Other identifiers 1

IdentifierTypeStateIssuer
7096338MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ, NV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081103000096 CA Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 0446319719 Reassigns benefits to 2 organizations
I20120216000149 AZ Practitioner - Pain ManagementPractitioner - Anesthesiology 0446319719 Reassigns benefits to 2 organizations
I20120718000803 NV Practitioner - Pain ManagementPractitioner - Anesthesiology 0446319719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
University of Arkansas College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

1665 S Imperial Ave
Suite D
El Centro, CA 92243-4247
Phone (760) 482-0212

1951 W 25TH St
Suite B
Yuma, AZ 85364-6924
Phone (928) 276-3049

2585 Miracle Mile
Bullhead City, AZ 86442-7522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as individual
Quality
52.14
Promoting interoperability
75
Improvement activities
40
Cost
72.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104563CAMDAddiction (Substance Use Disorder) Counselor
A104563CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles R Stevens M.D, Apc Pain Medicine CurrentSince Feb 10, 2009 Accepting new patients
Tucson Pain Institute PC Pain Medicine CurrentSince Feb 1, 2014 Accepting new patients
Blue River Health & Wellness, PLLC PastSince Jul 12, 2014 Accepting new patients
Dale Feinberg Past Accepting new patients
PHC-Fort Mohave Inc Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Charles R Stevens, M.D., Apc Past Accepting new patients

Locations

1520 E Hammer Ln
Ste 104
Fort Mohave, AZ 86426
Phone (928) 577-2727

5717 S Highway 95
Ste 6
Fort Mohave, AZ 86426
Phone (928) 276-3049

126 S Coronado Dr
Ste B
Sierra Vista, AZ 85635
Phone (520) 439-0115

6252 E Grant Rd
#150
Tucson, AZ 85712
Phone (520) 733-3030

1230 W 24th St
Ste 26
Yuma, AZ 85364

1951 W 25th St
Ste B
Yuma, AZ 85364
Phone (928) 247-6825

1665 S Imperial Ave
Ste D
El Centro, CA 92243
Phone (760) 352-5067

Interoperability endpoints

  • Direct secure messaging: charles.stevens.1@28063.direct.athenahealth.com
  • Direct secure messaging: charles.stevens.1@28349.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/28063/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/94fb32bd-11fc-46c8-aef4-90035a0718bb/
  • FHIR API: https://fhir.yourcareuniverse.net/tenant/1e652adb-d6d8-4094-bdfc-81d32d2a7070

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1003001363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 S IMPERIAL AVE STE D",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434247",
            "telephone_number": "760-482-0212",
            "fax_number": "760-482-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S IMPERIAL AVE STE D",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434247",
            "telephone_number": "760-482-0212",
            "fax_number": "760-482-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A104563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7096338",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.