Individual provider Active NPI

Kyle Marie Stiffler, MD

  • Psychiatry Physician
  • Bridgeton, NJ
National Provider Identifier
1164577227
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA06624000 Issued in NJ
Practice address
14 West Ave S
Bridgeton, NJ 08302
Phone
(856) 455-9911
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA06624000 NJ Primary

Addresses

Primary practice location

14 West Ave S
Bridgeton, NJ 08302

Mailing address

14 West Ave S
Bridgeton, NJ 08302
Phone (856) 455-9911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041216000027 NJ Practitioner - Psychiatry 3375500838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Healthcare Commons Inc.Group PAC ID 0547344434, 6 clinicians

Practice addresses (Care Compare)

500 S Pennsville Auburn Rd
Carneys Point, NJ 08069-2936
Phone 8562993200418

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Commons, Inc. CurrentSince Feb 15, 2012 Accepting new patients
Acenda, Inc. CurrentSince Dec 25, 2019 Accepting new patients
Healthcare Commons, Inc. CurrentSince Feb 15, 2012 Accepting new patients

Locations

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

500 S Pennsville Auburn Rd
Penns Grove, NJ 08069
Phone (856) 299-3200

404 Tatum St
Woodbury, NJ 08096
Phone (856) 845-8050

Interoperability endpoints

  • Direct secure messaging: healthcarecommons.kylestiffler@127476.advancedmd-direct.com

Organizations & group practices 3

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 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1164577227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WEST AVE S",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-455-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WEST AVE S",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-455-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIFFLER",
        "first_name": "KYLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA06624000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

Verify at the official NPI Registry.