Individual provider Active NPI

David W Stein, MD

  • Otolaryngology Physician
  • Fort Wayne, IN
National Provider Identifier
1215929930
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01037303A Issued in IN
Practice address
10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone
(260) 426-8117
Fax
(260) 420-0817
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 01037303A IN Primary

Addresses

Primary practice location

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604

Mailing address

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone (260) 426-8117

Other identifiers 2

IdentifierTypeStateIssuer
100355390MedicaidIN
0606124MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01037303AINMDOtolaryngology Physician

Interoperability endpoints

  • Direct secure messaging: dstein@entfortwayne.gwaydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1215929930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01037303A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355390",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0606124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.