Active NPI
Dean Walter Stoller, M.D.
- Family Medicine Physician
- Fair Oaks, CA
National Provider Identifier
1144547944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- CFE33373
- Practice address
- 8133 Shangrila Dr
Fair Oaks, CA 95628-6028 - Phone
- (916) 965-6677
- NPI assigned
- May 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | CFE33373 | CA | Primary |
Addresses
Primary practice location
8133 Shangrila Dr
Fair Oaks, CA 95628-6028
Mailing address
8133 Shangrila Dr
Fair Oaks, CA 95628-6028
Phone (916) 965-6677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CFE33373 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272844800000",
"number": "1144547944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8133 SHANGRILA DR",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956286028",
"telephone_number": "916-965-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8133 SHANGRILA DR",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956286028",
"telephone_number": "916-965-6677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLER",
"first_name": "DEAN",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-03",
"last_updated": "2010-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "CFE33373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.