Tristan Vaun Stonger, M.D.

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

01031765A Issued in IN

Practice address

1 S Broadway
Peru, IN 46970-2231

Phone

(765) 432-5294

Fax

(765) 472-7700

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Certified Surgeons, Inc.

  • Multi-Specialty Clinic/Center
  • Peru, IN
  • NPI 1427196476
  NPD (past) Authorized official
• Clear Tones Hearing

  • Hearing Instrument Specialist
  • Peru, IN
  • NPI 1649518747
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1134213796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469702231",
            "telephone_number": "765-432-5294",
            "fax_number": "765-472-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469702231",
            "telephone_number": "765-432-5294",
            "fax_number": "765-472-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONGER",
        "first_name": "TRISTAN",
        "middle_name": "VAUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MT",
            "license": "4581",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IN",
            "license": "01031765A",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MT",
            "license": "4581",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IN",
            "license": "01031765A",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "MT",
            "license": "4581",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "IN",
            "license": "01031765A",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MT",
            "license": "4581",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IN",
            "license": "01031765A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleotilde Sorgenfrei
• St Joseph Primary Care Physicians, LLC
• David Alan Stahl, BS
• Neil Stalker, MD
• Elizabeth Ann Stephens, CNS
• Megan Studebaker
• Amber Sturch, RN
• William Zachary Sturch, RN
• Andrew Swanagan, PTA
• Sara Tanner, PHARMD

• Plastic Surgery Physician in Peru, IN
• Providers in Peru, IN by specialty
• Plastic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.