Individual provider Active NPI

Stephen Wesley Line, DO

  • Family Medicine Physician
  • Bryan, TX
National Provider Identifier
1306342431
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S6243 Issued in TX
Practice address
3121 University Dr E Ste 100
Bryan, TX 77802-3499
Phone
(979) 776-0169
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S6243 TX Primary
Family Medicine Physician 207Q00000X BP10063117 TX

Addresses

Primary practice location

3121 University Dr E Ste 100
Bryan, TX 77802-3499

Mailing address

8441 State Hwy 47
Ste 3115
Bryan, TX 77807
Phone (979) 436-9703

Other practice location 1

1228 Tamu
College Station, TX 77843-1923
Phone (979) 845-3121

Other practice location 2

2900 E 29th St
Bryan, TX 77802-2622
Phone (979) 436-0485

Other identifiers 1

IdentifierTypeStateIssuer
2J5586OtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220729002959 TX Practitioner - Family Practice 2062894546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2900 E 29TH St
Suite 200
Bryan, TX 77802-2623
Phone (979) 776-8440

3121 University Dr E
100 Central Texas Sports Medicine and Ort
Bryan, TX 77802-3499
Phone (979) 776-0169

Hospital & facility affiliations

  • Traditions Health Home health agency, College Station, TX, CCN 457877
  • Physicians Centre,the Hospital, Bryan, TX, CCN 450834

Merit-based Incentive Payment System (MIPS)

Final score
79.62 of 100Reported as group
Quality
58.26
Promoting interoperability
97
Improvement activities
40
Cost
76.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10063117TXMDFamily Medicine Physician
S6243TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center Family Medicine CurrentSince Sep 22, 2022 Accepting new patients
Brazos Valley Physicians Alliance Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
Texas a&M University System Health Science Center CurrentSince Sep 22, 2022 Accepting new patients
Brazos Valley Physicians Alliance CurrentSince Jun 1, 2022 Accepting new patients

Locations

3201 University Dr E
Ste 3
Bryan, TX 77802
Phone (979) 704-5029

2900 E 29th St
Ste 200
Bryan, TX 77802
Phone (979) 436-0483

2900 E 29th St
Bryan, TX 77802
Phone (979) 436-0700

3201 University Dr E
Ste 455
Bryan, TX 77802
Phone (979) 704-5029

3121 University Dr E
Ste 100
Bryan, TX 77802
Phone (979) 776-0169

1301 Memorial Dr
Ste 100
Bryan, TX 77802
Phone (979) 862-4465

2900 E 29th St
Ste 100
Bryan, TX 77802
Phone (979) 436-0485

Interoperability endpoints

  • Direct secure messaging: sline32558@texasamuniversity.gardenplot.direct-ci.com
  • Direct secure messaging: stephen.line.1@25466.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1306342431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 STATE HWY 47",
            "address_2": "STE 3115",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77807",
            "telephone_number": "979-436-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 UNIVERSITY DR E STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023499",
            "telephone_number": "979-776-0169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1228 Tamu",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778431923",
            "country_code": "US",
            "telephone_number": "979-845-3121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 E 29th St",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778022622",
            "country_code": "US",
            "telephone_number": "979-436-0485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINE",
        "first_name": "STEPHEN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S6243",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10063117",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2J5586",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.