NPIMap

Individual provider Active NPI

Cary C Stewart, M.D.

  • Internal Medicine Physician
  • San Clemente, CA
National Provider Identifier
1184690901
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A69557 Issued in CA
Practice address
1001 Avenida Pico
Suite C
San Clemente, CA 92673-6957
Phone
(949) 542-6154
Fax
(949) 542-7154
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A69557 CA Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A69557 CA

Addresses

Primary practice location

1001 Avenida Pico
Suite C
San Clemente, CA 92673-6957

Mailing address

1001 Avenida Pico
Suite C
San Clemente, CA 92673-6957
Phone (949) 542-6154

Other identifiers 1

IdentifierTypeStateIssuer
00A695570MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041025001221 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 0547221285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

San Clemente, CA 92673
Phone (949) 542-6154

Hospital & facility affiliations

  • Bear Valley Hospice LLC Hospice, Big Bear City, CA, CCN 751713
  • Nurses Plus Hospice Hospice, Artesia, CA, CCN 551523
  • Bear Valley Community Hospital Hospital, Big Bear Lake, CA, CCN 051335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wieler & Sein Medical Group Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Seasons of Life Hospice, LLCLake Forest, CA, CCN 551773 Hospice 5% Or Greater Direct Ownership Interest (14.28%)
Corporate Director (33.34%)
W-2 Managing Employee (100%)		 Feb 29, 2012
Feb 29, 2012
Feb 29, 2012
Bear Valley Hospice LLCBig Bear City, CA, CCN 751713 Hospice 5% Or Greater Direct Ownership Interest (25%)
Corporate Director (25%)
W-2 Managing Employee (25%)		 Nov 29, 2013
Nov 29, 2013
Nov 29, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 3

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1184690901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO",
            "address_2": "SUITE C",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736957",
            "telephone_number": "949-542-6154",
            "fax_number": "949-542-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO",
            "address_2": "SUITE C",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736957",
            "telephone_number": "949-542-6154",
            "fax_number": "949-542-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69557",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A69557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A695570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.