Individual provider Active NPI

Charles I Stein, MD

  • Phlebology Physician
  • Palm Coast, FL
National Provider Identifier
1174545479
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
ME39243 Issued in FL
Practice address
21 Hospital Dr
Suite 260
Palm Coast, FL 32164-2452
Phone
(386) 586-5344
Fax
(386) 586-5356
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME 39243 FL
Gynecology Physician 207VG0400X ME 39243 FL
Phlebology Physician 202K00000X ME39243 FL Primary

Addresses

Primary practice location

21 Hospital Dr
Suite 260
Palm Coast, FL 32164-2452

Mailing address

PO Box 730657
Ormond Beach, FL 32173-0657
Phone (386) 445-5340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040626000433 FL Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 5193701530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Center of Orlando, P.a.Group PAC ID 5294796132, 8 clinicians

Practice addresses (Care Compare)

1200 Edgewater Dr
Orlando, FL 32804-6314
Phone (407) 244-8560

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 39243FLMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Center of Orlando, P.a. CurrentSince Dec 1, 2021 Accepting new patients

Locations

121 Webb Dr
Ste 300
Davenport, FL 33837
Phone (863) 291-6313

1210 E Osceola Pkwy
Ste 303
Kissimmee, FL 34744
Phone (407) 847-8404

4106 W Lake Mary Blvd
Ste 325
Lake Mary, FL 32746
Phone (386) 256-1969

100 N Dean Rd
Ste 201
Orlando, FL 32825
Phone (407) 244-8559

1200 Edgewater Dr
Orlando, FL 32804
Phone (407) 244-8559

910 Old Camp Rd
Ste 164
The Villages, FL 32162
Phone (352) 430-2720

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1174545479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730657",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730657",
            "telephone_number": "386-445-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642452",
            "telephone_number": "386-586-5344",
            "fax_number": "386-586-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "CHARLES",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME 39243",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME 39243",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME39243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.