NPIMap

Individual provider Active NPI

Stephen David Surgenor, M.D.

  • Critical Care Medicine (Anesthesiology) Physician
  • Lebanon, NH
National Provider Identifier
1194740233
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
9909 Issued in NH
Practice address
1 Medical Center Dr
DHMC - Department of Anesthesiology
Lebanon, NH 03756-1000
Phone
(603) 650-4642
Fax
(603) 650-0614
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 9909 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
DHMC - Department of Anesthesiology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC - Department of Anesthesiology
Lebanon, NH 03756-1000

Other identifiers 2

IdentifierTypeStateIssuer
30200040MedicaidNH
0RE5053MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040217000209 NH Practitioner - Critical Care (Intensivists)Practitioner - Anesthesiology 4688569908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Anesthesiology
Education
University of Vermont College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 17, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 4, 1999 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 17, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Windsor Hospital Corporation PastSince Jul 1, 2014 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: ssurgenor16824@direct.dartmouth-hitchcock.org

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Valley Regional Hospital IncClaremont, NH, CCN 301308 Hospital Corporate Director Jan 1, 2014
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 471302 Hospital Corporate Director Jul 1, 2014
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 47Z302 Hospital Corporate Director Jul 1, 2014
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 47R302 Hospital Corporate Director Jul 1, 2014
Valley Regional Hospital IncClaremont, NH, CCN 30Z308 Hospital Corporate Director Jan 1, 2014

Owned or controlled facilities with NPI records 7

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

Organizations & group practices 5

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 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1194740233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - DEPARTMENT OF ANESTHESIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - DEPARTMENT OF ANESTHESIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-4642",
            "fax_number": "603-650-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURGENOR",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NH",
            "license": "9909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200040",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0RE5053",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.