NPIMap

Individual provider Active NPI

Stephen Lackey Chastain, M.D.

  • Cardiovascular Disease Physician
  • Stuart, FL
National Provider Identifier
1194784256
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME114042 Issued in FL
Practice address
5850 SE Community Dr
Stuart, FL 34997-6420
Phone
(772) 324-3500
NPI assigned
Mar 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00014657 AL
Internal Medicine Physician 207R00000X 33627 SC
Cardiovascular Disease Physician 207RC0000X ME114042 FL Primary
Internal Medicine Physician 207R00000X ME114042 FL

Addresses

Primary practice location

5850 SE Community Dr
Stuart, FL 34997-6420

Mailing address

9611 N US Highway 1
#166
Sebastian, FL 32958-6363
Phone (772) 581-3990

Other identifiers 3

IdentifierTypeStateIssuer
00083765MedicaidAL
336274MedicaidSC
51083765OtherALBLUE CROSS BLUE SHIELD

Other names 1

  • Stephen Lackey Chastain Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130717000043 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5193703015 Receives reassigned benefits from 2 practitioners
Practice locations: Stuart, FL

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Alabama School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5850 Secommunity Dr
Stuart, FL 34997-6420
Phone (772) 324-3500

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • Visiting Nurse Association of Florida Inc Home health agency, Stuart, FL, CCN 107177
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260
  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253
  • CCN 100366 Hospital, CCN 100366
  • HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246
  • Encompass Health Rehab Hospital an Affiliate of Ma Inpatient rehabilitation facility, Stuart, FL, CCN 103044

Merit-based Incentive Payment System (MIPS)

Final score
91.99 of 100Reported as group
Quality
100
Improvement activities
40
Cost
56.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00014657ALMDInternal Medicine Physician
33627SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Stephen Lacky Chastain Cardiovascular Disease PastSince Jun 1, 2013 Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

201 Doctors Dr
Dothan, AL 36301
Phone (334) 794-6611

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Hospital & facility affiliations 8

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1194784256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 N US HIGHWAY 1",
            "address_2": "#166",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586363",
            "telephone_number": "772-581-3990",
            "fax_number": "772-581-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 SE COMMUNITY DR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976420",
            "telephone_number": "772-324-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "STEPHEN",
        "middle_name": "LACKEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00014657",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "33627",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME114042",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME114042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00083765",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336274",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51083765",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "CHASTAIN",
            "middle_name": "LACKEY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.