Active NPI
Jeffrey L. Stone, MD
- Surgery Physician
- Renton, WA
National Provider Identifier
1194767509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD60360724
- Practice address
- 4011 Talbot Rd S
Renton, WA 98055 - Phone
- (425) 228-6076
- Fax
- (425) 226-5224
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD2004-0818 | NM | |
| Surgery Physician | 208600000X | 4310 | MT | |
| Surgery Physician | 208600000X | MD60360724 | WA | Primary |
Addresses
Primary practice location
4011 Talbot Rd S
Renton, WA 98055
Mailing address
3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057
Phone (425) 228-3440
Other practice location 1
1631 Hospital Dr
Santa Fe, NM 87505-4728
Phone (505) 913-3975
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2037324 | Medicaid | WA | |
| 634686754 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4310 | MT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Montana Medical Facilities, Inc. | Surgery | Past | Accepting new patients |
| Central Montana Medical Facilities, Inc | Past | Accepting new patients |
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.
-
- Critical Access Hospital
- Lewistown, MT
- NPI 1790798387
-
- Family Medicine Physician
- Lewistown, MT
- NPI 1497868814
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1194767509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 LIND AVE SW",
"address_2": "SUITE 100 ATTN CREDENTIALING",
"city": "RENTON",
"state": "WA",
"postal_code": "98057",
"telephone_number": "425-228-3440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4011 TALBOT RD S",
"city": "RENTON",
"state": "WA",
"postal_code": "98055",
"telephone_number": "425-228-6076",
"fax_number": "425-226-5224"
}
],
"practiceLocations": [
{
"address_1": "1631 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Santa Fe",
"state": "NM",
"postal_code": "875054728",
"country_code": "US",
"telephone_number": "505-913-3975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STONE",
"first_name": "JEFFREY",
"middle_name": "L.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-11",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "MD2004-0818",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MT",
"license": "4310",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD60360724",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2037324",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "634686754",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.