Samuel R Stevens, M.D.
Individual provider Active NPI Family Medicine Physician · Jackson, WI
NPI 1306379698 · NPPES record last updated Jun 30, 2020
Key facts
- NPI
- 1306379698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 70288-20 (WI)
- Practice address
- W225N16711 Cedar Park CT
Jackson, WI 53037-9222 - Phone
- (262) 677-1101
- NPI assigned
- Apr 4, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Froedtert Andthe Medical College of Wisconsin Community Physicians Inc
Practice addresses (Care Compare)
W225N16711 Cedar Park CT
Jackson, WI 53037-9222
Phone (262) 677-1101
Hospital & facility affiliations
- Horizon Home Care and Hospice
- Aveanna Home Health
- St Josephs Community Hospital West Bend
- Community Memorial Hospital
- Froedtert Memorial Lutheran Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200928003167 | WI | Practitioner - Family Practice | 9436487253 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
W225N16711 Cedar Park Ct
Jackson, WI 53037
Phone (262) 323-9257
W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
Interoperability endpoints
- sstevensmd213136@direct.froedtert.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 70288-20 | WI | Yes |
Addresses
Primary practice location
W225N16711 Cedar Park CT
Jackson, WI 53037-9222
Mailing address
W225N16711 Cedar Park CT
Jackson, WI 53037-9222
Phone (262) 677-1101
Other providers in Jackson, WI
- Mark Seip
- Shannon Skowron
- SNH SE Tenant TRS, Inc
- Linda Soulad
- Laura Jean Steinmetz
- Rachel Telschow
- The Lactation Network, LLC
- Jennifer Lynn Thompson
- Amy C Truog
- Marc A Vaughan
All providers in Jackson, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.