Individual provider Active NPI

Robert J Stierwalt, MD

  • Internal Medicine Physician
  • Maumee, OH
National Provider Identifier
1326019969
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35046716 Issued in OH
Practice address
5901 Monclova Rd
Maumee, OH 43537-1855
Phone
(419) 893-5968
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35046716 OH Primary
Emergency Medicine Physician 207P00000X 35.046716 OH

Addresses

Primary practice location

5901 Monclova Rd
Maumee, OH 43537-1855

Mailing address

7280 Sawmill Run
Holland, OH 43528-9687
Phone (419) 867-0715

Other identifiers 1

IdentifierTypeStateIssuer
0537986MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20101108000646 OH Practitioner - Emergency Medicine 3173718863 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35046716OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 31, 2002 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 31, 2002 Accepting new patients

Locations

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

930 S Detroit Ave
Toledo, OH 43614
Phone (419) 381-1881

Interoperability endpoints

  • Direct secure messaging: robert.stierwalt.1@20880.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1326019969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 SAWMILL RUN",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289687",
            "telephone_number": "419-867-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371855",
            "telephone_number": "419-893-5968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIERWALT",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35046716",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.046716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0537986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.