Samuel R Stevens, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

70288-20 Issued in WI

Practice address

W225N16711 Cedar Park CT
Jackson, WI 53037-9222

Phone

(262) 677-1101

NPI assigned

Apr 4, 2017

Last updated

Jun 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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 IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Horizon Home Care and Hospice Home health agency, Milwaukee, WI, CCN 527083
• Aveanna Home Health Home health agency, Brookfield, WI, CCN 527273
• St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063
• Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sstevensmd213136@direct.froedtert.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Hospital of Menomonee Falls Inc

  dba Froedtert Menomonee Falls Hospital

  • General Acute Care Hospital
  • Menomonee Falls, WI
  • NPI 1609822881
  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  dba CDI-Froedtert Memorial Lutheran Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation
• Horizon Home Care & Hospice, Inc.

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1780687327
  Care Compare affiliation
• Recover Health of Wisconsin, Inc.

  dba Aveanna Home Health

  • Home Health Agency
  • Brookfield, WI
  • NPI 1710967104
  Care Compare affiliation
• St. Josephs Community Hospital of West Bend Inc.

  dba Froedtert West Bend Hospital

  • General Acute Care Hospital
  • West Bend, WI
  • NPI 1851336044
  Care Compare affiliation

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1306379698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W225N16711 CEDAR PARK CT",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379222",
            "telephone_number": "262-677-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W225N16711 CEDAR PARK CT",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379222",
            "telephone_number": "262-677-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "70288-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Seip, R.PH.
• Shannon Skowron, APNP
• SNH SE Tenant TRS, Inc (The Landmark at Jackson Crossings)
• Linda Soulad, CSAC, CT-IT
• Laura Jean Steinmetz, LPN
• Rachel Telschow, M.S., R.D., L.D.
• The Lactation Network, LLC
• Jennifer Lynn Thompson, OTR
• Amy C Truog, DPT
• Marc A Vaughan, PHARMD

• Family Medicine Physician in Jackson, WI
• Providers in Jackson, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.