Individual provider Active NPI

Kurtis Alan Stewart, MD

  • Surgery Physician
  • Shoreline, WA
National Provider Identifier
1306004676
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60555216 Issued in WA
Practice address
19930 Ballinger Way NE
Shoreline, WA 98155-1223
Phone
(425) 778-2220
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60555216 WA Primary

Addresses

Primary practice location

19930 Ballinger Way NE
Shoreline, WA 98155-1223

Mailing address

19930 Ballinger Way NE
Shoreline, WA 98155-1223
Phone (425) 778-2220

Other identifiers 1

IdentifierTypeStateIssuer
MD60555216OtherWAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20201019000372 IL Practitioner - General Surgery 9739305699 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Toledo College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak
Peoria, IL 61636-0001
Phone (309) 672-5522

221 NE Glen Oak Ave
Peoria, IL 61636-0001

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

900 Main St
Suite 100
Peoria, IL 61602-5003
Phone (309) 672-4202

900 Main St
Suite 470And490
Peoria, IL 61602-1005
Phone (309) 672-4565

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services Corporation of Southern Illinois Inc. Surgery CurrentSince May 1, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2024 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2024 Accepting new patients
Carle West Physician Group Inc CurrentSince Apr 7, 2023 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

815 Main St
Ste A1
Peoria, IL 61602

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: kstewardmd370800@carlehiedirect.net

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 3

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1306004676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KURTIS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60555216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD60555216",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.