NPIMap

Individual provider Active NPI

Charles Blanchard Stoer, MD

  • Dermatology Physician
  • Gainesville, FL
National Provider Identifier
1164550232
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0044326 Issued in FL
Practice address
4525 SW 13TH St
Gainesville, FL 32608-3901
Phone
(352) 377-8619
Fax
(352) 371-9674
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME0044326 FL Primary
MOHS-Micrographic Surgery Physician 207ND0101X ME0044326 FL

Addresses

Primary practice location

4525 SW 13TH St
Gainesville, FL 32608-3901

Mailing address

4525 SW 13TH St
Gainesville, FL 32608-3901
Phone (352) 377-8619

Other identifiers 1

IdentifierTypeStateIssuer
040704600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051206000218 FL Practitioner - Dermatology 1153341110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in Shreveport, 1980
Medicare assignment
May accept Medicare assignment
Group practices
Charles Blanchard Stoer MD PAGroup PAC ID 3971523937, 5 clinicians

Practice addresses (Care Compare)

4525 SW 13TH St
Gainesville, FL 32608-3901

Hospital & facility affiliations

  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
91.75 of 100Reported as individual
Quality
85
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision38
Removal of skin lesions22
Removal of skin cancer491
Removal of nail tissue1-10
Skin biopsy99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0044326FLMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Blanchard Stoer MD PA Dermatology CurrentSince Oct 3, 2005 Accepting new patients
Douglas K Pierce MD PA PastSince Oct 31, 2021 Accepting new patients

Locations

4525 SW 13th St
Gainesville, FL 32608
Phone (352) 377-8619

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1164550232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083901",
            "telephone_number": "352-377-8619",
            "fax_number": "352-371-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083901",
            "telephone_number": "352-377-8619",
            "fax_number": "352-371-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOER",
        "first_name": "CHARLES",
        "middle_name": "BLANCHARD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0044326",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME0044326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040704600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.