Individual provider Active NPI

Paul George Stumpf, M.D.

  • Reproductive Endocrinology Physician
  • Summit, NJ
National Provider Identifier
1235195801
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
46854 Issued in TN
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(423) 778-2580
Fax
(423) 778-7489
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 12519 NV
Gynecology Physician 207VG0400X 12519 NV
Reproductive Endocrinology Physician 207VE0102X 46854 TN Primary
Gynecology Physician 207VG0400X 46854 TN

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (973) 971-4179

Other identifiers 10

IdentifierTypeStateIssuer
880330858OtherNVMEDIVERSAL, INC.
3719461-005OtherNJCIGNA HEALTHCARE
4820OtherNVEVOLUTIONS
880330858OtherNVANTHEM BC/BS
294636OtherNVAHCCCS
880330858OtherNVGREAT-WEST HEALTHCARE
1001205MedicaidNJ
1235195801MedicaidNV
223680351OtherNJTHE FIRST HEALTH NETWORK
880330858OtherNVTEACHERS HEALTH TRUST

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

LicenseStateTypeSpecialty
12519NVMDReproductive Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1235195801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-971-4179",
            "fax_number": "973-971-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "423-778-2580",
            "fax_number": "423-778-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMPF",
        "first_name": "PAUL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NV",
            "license": "12519",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NV",
            "license": "12519",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "TN",
            "license": "46854",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TN",
            "license": "46854",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIVERSAL, INC.",
            "identifier": "880330858",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "3719461-005",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOLUTIONS",
            "identifier": "4820",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "880330858",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "294636",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT-WEST HEALTHCARE",
            "identifier": "880330858",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001205",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235195801",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE FIRST HEALTH NETWORK",
            "identifier": "223680351",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEACHERS HEALTH TRUST",
            "identifier": "880330858",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.