Individual provider Active NPI

Elliott Martin Stein, M.D.

  • Geriatric Psychiatry Physician
  • Mill Valley, CA
National Provider Identifier
1154379089
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
G27964 Issued in CA
Practice address
535 Midvale Way
Mill Valley, CA 94941-3705
Phone
(156) 729-3524
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G27964 CA
Psychiatry Physician 2084P0800X ME 30436 FL
Geriatric Psychiatry Physician 2084P0805X ME 30436 FL
Geriatric Psychiatry Physician 2084P0805X G27964 CA Primary

Addresses

Primary practice location

535 Midvale Way
Mill Valley, CA 94941-3705

Mailing address

535 Midvale Way
Mill Valley, CA 94941-3705
Phone (415) 672-9352

Other identifiers 2

IdentifierTypeStateIssuer
92798OtherFLBLUE CROSS/BLUE SHIELD FL
059518700MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100816000056 CA Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 9931265477 Practice locations: Mill Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
University of Miami, LM Miller School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

535 Midvale Way
Mill Valley, CA 94941-3705
Phone (415) 672-9352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G27964CAMDGeriatric Psychiatry Physician
ME 30436FLMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott M Stein MD PA Psychiatry PastSince Oct 1, 2008 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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1154379089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MIDVALE WAY",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413705",
            "telephone_number": "415-672-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MIDVALE WAY",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413705",
            "telephone_number": "156-729-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "ELLIOTT",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G27964",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 30436",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME 30436",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "G27964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD FL",
            "identifier": "92798",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059518700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.