Michael Stoddard

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

60862 Issued in AZ

Practice address

4175 S Alamo Ave
Davis-Monthan Afb, AZ 85707-4405

Phone

(520) 228-4357

NPI assigned

May 2, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Psychiatry

Education

University of Arizona College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  AZ

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1316392079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "DAVIS-MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "DAVIS-MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074405",
            "telephone_number": "520-228-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2022-02-04",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "60862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah J Ostrom, PA-C
• Isabella Ruiz, PHARMD, RPH
• Esmat Marie Sabbagh, IDMT
• Jennifer Saulnier, MD
• Derek Snare, D.M.D.
• Andrew Joseph Stoy, D.D.S. , M.S.
• Sarah Elizabeth Szybist, DO
• Natalie Tobar
• Virginia Ann Underwood, M.D.
• Usv Optical Inc.

• Psychiatry Physician in Davis-Monthan Afb, AZ
• Providers in Davis-Monthan Afb, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.