Organization Active NPI

Stamatin Internal Medicine PC

  • Internal Medicine Physician
  • Rochester Hills, MI
National Provider Identifier
1356426506
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STAMATIN INTERNAL MEDICINE PC
Practice address
330 W Tienken Rd
Suite C
Rochester Hills, MI 48306-4474
Phone
(248) 651-2620
Fax
(248) 651-9450
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Rica Stamatin, MDNPI 1316937071
Title
Owner
Phone
(248) 651-2620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

330 W Tienken Rd
Suite C
Rochester Hills, MI 48306-4474

Mailing address

330 W Tienken Rd
Suite C
Rochester Hills, MI 48306-4474
Phone (248) 651-2620

Other identifiers 1

IdentifierTypeStateIssuer
DD4492OtherMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020001108 MI Part B Supplier - Clinic/Group Practice 5294796538 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

111 Rochdale Dr S
Ste B
Rochester Hills, MI 48309
Phone (248) 651-2620

2710 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 853-9097

2710 S Rochester Rd
Ste 4
Rochester Hills, MI 48307
Phone (248) 651-2620

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1356426506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W TIENKEN RD",
            "address_2": "SUITE C",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064474",
            "telephone_number": "248-651-2620",
            "fax_number": "248-651-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W TIENKEN RD",
            "address_2": "SUITE C",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064474",
            "telephone_number": "248-651-2620",
            "fax_number": "248-651-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMATIN INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "STAMATIN",
        "authorized_official_first_name": "RICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-651-2620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DD4492",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.