Stephen John Croughan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A41669 Issued in CA

Practice address

2937 Beyer Blvd
San Diego, CA 92154

Phone

(310) 627-2378

Fax

(801) 749-4963

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Yucca Valley Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Yucca Valley, CA
  • NPI 1518381367
  Medicare reassignment NPD
• Avalon Pediatrics, Inc.

  • Pediatrics Physician
  • Pismo Beach, CA
  • NPI 1386916138
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1043323629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 927704",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921927704",
            "telephone_number": "310-627-2378",
            "fax_number": "619-423-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 BEYER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92154",
            "telephone_number": "310-627-2378",
            "fax_number": "801-749-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUGHAN",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A41669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A416690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dannielle Amber Crouch
• Molly Crouch
• Sara Crouch, LCSW
• Zachary Alan Crouch
• Carmen Croucher, LPCC
• Abigail Croughwell
• Paula Lindsay Crouse, R.N.
• Haleigh Crouson
• Keri Crovella
• Amanda Renee Crow, PA-C

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.