NPIMap

Individual provider Active NPI

Charles Wilbur Stotler, MD

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1114998333
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD017069E Issued in PA
Practice address
334 Bloomfield St
Ste 205
Johnstown, PA 15904
Phone
(814) 266-8686
Fax
(814) 266-6478
NPI assigned
Jan 27, 2006
Last updated
Apr 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD017069E PA Primary

Addresses

Primary practice location

334 Bloomfield St
Ste 205
Johnstown, PA 15904

Mailing address

334 Bloomfield St
Ste 205
Johnstown, PA 15904
Phone (814) 266-8686

Other identifiers 1

IdentifierTypeStateIssuer
000746670003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912000627 PA Practitioner - Family PracticePractitioner - Other (Physician) 0749213700 Receives reassigned benefits from 4 practitioners
Practice locations: Portage, PA; Johnstown, PA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

334 Bloomfield St
Suite 205
Johnstown, PA 15904-3269
Phone (814) 266-8686

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

711 Caldwell Ave
Portage, PA 15946-1557
Phone (814) 736-9628

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD017069EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles W. Stotler, M.D. Family Medicine PastSince Jan 1, 1990 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Maple Winds Healthcare and Rehabilitation Center, LLC Past Accepting new patients
Charles W. Stotler PastSince Jan 1, 1990 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1114998333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 BLOOMFIELD ST",
            "address_2": "STE 205",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-8686",
            "fax_number": "814-266-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BLOOMFIELD ST",
            "address_2": "STE 205",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-8686",
            "fax_number": "814-266-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTLER",
        "first_name": "CHARLES",
        "middle_name": "WILBUR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD017069E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000746670003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.