Individual provider Active NPI

Stephen W Samelson, M.D.

  • Orthopaedic Surgery Physician
  • Montgomery, AL
National Provider Identifier
1265492441
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
00021227 Issued in AL
Practice address
454 Taylor Rd
Montgomery, AL 36117-3563
Phone
(334) 613-9000
Fax
(334) 532-0056
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 00021227 AL Primary

Addresses

Primary practice location

454 Taylor Rd
Montgomery, AL 36117-3563

Mailing address

454 Taylor Rd
Montgomery, AL 36117-3563
Phone (334) 613-9000

Other identifiers 10

IdentifierTypeStateIssuer
0910392OtherALUNITED HEALTHCARE
515-02603OtherALBCBS
009963920MedicaidAL
515-02207OtherALBCBS
009963930MedicaidAL
009963940MedicaidAL
000097168MedicaidAL
515-03737OtherALBCBS
200039175OtherRAILROAD MEDICARE
510-97168OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080423000255 AL Practitioner - Orthopedic Surgery 1355352550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alabama School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

454 Taylor Rd
Montgomery, AL 36117-3563
Phone (334) 613-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement23
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)37
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00021227ALMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopaedic Surgeons, LLC Orthopaedic Surgery CurrentSince Aug 18, 2000 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 3, 2021 Accepting new patients
Southern Orthopaedic Surgeons, LLC CurrentSince Aug 18, 2000 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 3, 2021 Accepting new patients

Locations

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

454 Taylor Rd
Montgomery, AL 36117

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

7449 Eastchase Pkwy
Montgomery, AL 36117
Phone (334) 747-4030

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

668 McQueen Smith Rd N
Prattville, AL 36066

80 Herren Hill Rd
Ste G
Tallassee, AL 36078

Interoperability endpoints

  • Direct secure messaging: stephen.samelson@direct.baptistfirst.org

Organizations & group practices 5

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 7

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1265492441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000",
            "fax_number": "334-532-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000",
            "fax_number": "334-532-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMELSON",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "00021227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0910392",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-02603",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009963920",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-02207",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009963930",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009963940",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000097168",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-03737",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200039175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-97168",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.