Active NPI
Michael L Stoltz, MD
- Nephrology Physician
- Fort Worth, TX
National Provider Identifier
1104862226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- E1766
- Practice address
- 950 W Magnolia Ave
Fort Worth, TX 76104 - Phone
- (817) 336-5060
- Fax
- (817) 336-1744
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | E1766 | TX | Primary |
Addresses
Primary practice location
950 W Magnolia Ave
Fort Worth, TX 76104
Mailing address
950 W Magnolia Ave
Fort Worth, TX 76104
Phone (817) 336-5060
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1646440 | Other | LA | UNISYS MEDICAID |
| 834763 | Other | TX | BLUE CROSS BLUE SHIELD |
| 4036178 | Other | AETNA | |
| 10013403 | Other | AMERIGROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1766 | TX | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dialysis Associates | Nephrology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Nephrology Physician
- Fort Worth, TX
- NPI 1346250446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104862226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 W MAGNOLIA AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76104",
"telephone_number": "817-336-5060",
"fax_number": "817-336-1744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 W MAGNOLIA AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76104",
"telephone_number": "817-336-5060",
"fax_number": "817-336-1744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLTZ",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "E1766",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISYS MEDICAID",
"identifier": "1646440",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "834763",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4036178",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10013403",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.