Individual provider Active NPI

Jeremy S Stiffler, PT

  • Physical Therapist
  • Bel Air, MD
National Provider Identifier
1215908751
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21192 Issued in MD
Practice address
407 E Churchville Rd
Suite 201
Bel Air, MD 21014-3844
Phone
(410) 638-5525
Fax
(410) 638-5558
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 21192 MD Primary

Addresses

Primary practice location

407 E Churchville Rd
Suite 201
Bel Air, MD 21014-3844

Mailing address

407 E Churchville Rd
Suite 201
Bel Air, MD 21014-3844
Phone (410) 638-5525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041118000435 MD Practitioner - Physical Therapist in Private Practice 9234193251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Medal Physical Therapy LLCGroup PAC ID 6800797911, 5 clinicians

Practice addresses (Care Compare)

407 E Churchville Rd
Suite 102
Bel Air, MD 21014-3846
Phone (410) 638-5525

Merit-based Incentive Payment System (MIPS)

Final score
80.66 of 100Reported as individual
Quality
78.33
Improvement activities
40
Cost
64.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Medal Physical Therapy LLC Physical Therapist CurrentSince Sep 13, 2004 Accepting new patients

Locations

407 E Churchville Rd
Ste 102
Bel Air, MD 21014
Phone (410) 529-2348

Organizations & group practices 1

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1215908751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E CHURCHVILLE RD",
            "address_2": "SUITE 201",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143844",
            "telephone_number": "410-638-5525",
            "fax_number": "410-638-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E CHURCHVILLE RD",
            "address_2": "SUITE 201",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143844",
            "telephone_number": "410-638-5525",
            "fax_number": "410-638-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIFFLER",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.