Individual provider Active NPI

Philip J Stella, M.D.

  • Medical Oncology Physician
  • Ypsilanti, MI
National Provider Identifier
1194725671
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
4301040900 Issued in MI
Practice address
5301 E Huron River Dr
Ste C-139
Ypsilanti, MI 48197-1051
Phone
(734) 712-1000
Fax
(734) 712-1012
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 4301040900 MI Primary

Addresses

Primary practice location

5301 E Huron River Dr
Ste C-139
Ypsilanti, MI 48197-1051

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other identifiers 1

IdentifierTypeStateIssuer
1857745MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101103000936 MI Practitioner - Hematology/OncologyPractitioner - Medical Oncology 1052382660 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301040900MIMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation CurrentSince Jul 15, 2011 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

7575 Grand River Rd
Ste 208
Brighton, MI 48114
Phone (810) 844-7740

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5301 E Huron River Dr
Ste C139
Ypsilanti, MI 48197
Phone (734) 712-1000

Interoperability endpoints

  • Direct secure messaging: pstella37252@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1194725671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "address_2": "STE C-139",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-1000",
            "fax_number": "734-712-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLA",
        "first_name": "PHILIP",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "4301040900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1857745",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.