NPIMap

Individual provider Active NPI

Stephen Charles Schreck, MD

  • Cardiovascular Disease Physician
  • Dayton, OH
National Provider Identifier
1164421632
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35045024 Issued in OH
Practice address
122 Wyoming St
Dayton, OH 45409-2731
Phone
(937) 223-4461
Fax
(937) 224-1945
NPI assigned
Jul 18, 2005
Last updated
Nov 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35045024 OH Primary

Addresses

Primary practice location

122 Wyoming St
Dayton, OH 45409-2731

Mailing address

122 Wyoming St
Dayton, OH 45409-2731
Phone (937) 223-4461

Other identifiers 2

IdentifierTypeStateIssuer
0553235MedicaidOH
000000005909OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091027000507 OH Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4789588286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

3006 N County Rd
25A Suite 104
Troy, OH 45373-1373
Phone (937) 277-4274

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35045024OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Cardiovascular Disease Current Accepting new patients
Premier Health Specialists Inc Cardiovascular Disease CurrentSince Oct 1, 2009 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 1, 2009 Accepting new patients
Miami Valley Hospital Past Accepting new patients
Major Hospital Past Accepting new patients
Miami Valley Cardiologists Inc. Cardiovascular Disease Past Accepting new patients
Premier Heart Associates, Inc Cardiovascular Disease Past Accepting new patients

Locations

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3006 N Dixie Hwy
Ste 104
Troy, OH 45373
Phone (937) 277-4274

Organizations & group practices 7

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1164421632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092731",
            "telephone_number": "937-223-4461",
            "fax_number": "937-224-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092731",
            "telephone_number": "937-223-4461",
            "fax_number": "937-224-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "STEPHEN",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35045024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0553235",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000005909",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.