Michael Trace Stafford, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DO.2013 Issued in AL

Practice address

1123 Belleville Ave
Brewton, AL 36426-1505

Phone

(251) 867-8001

Fax

(251) 867-9643

NPI assigned

Jul 3, 2014

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 AL

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

General Surgery

Education

West Virginia School of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

DW McMillan Surgical Group LLCGroup PAC ID 3870909740, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• D W McMillan Memorial Hospital Hospital, Brewton, AL, CCN 010099
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Evergreen Medical Center Hospital, Evergreen, AL, CCN 010148

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• DW McMillan Surgical Group LLC

  • Surgery Physician
  • Brewton, AL
  • NPI 1093304644
  Medicare reassignment Care Compare group NPD

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

• D. W. McMillan Memorial Hospital

  • General Acute Care Hospital
  • Brewton, AL
  • NPI 1609811538
  Care Compare affiliation
• Evergreen Medical Center LLC

  • General Acute Care Hospital
  • Evergreen, AL
  • NPI 1891770368
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1356757991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261505",
            "telephone_number": "251-867-8001",
            "fax_number": "251-867-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261505",
            "telephone_number": "251-867-8001",
            "fax_number": "251-867-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "MICHAEL",
        "middle_name": "TRACE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "DO.2013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skill Builders OT Services, LLC
• Tommy Wayne Smith
• Maria Gabrielle Solomon
• Southern Orthopaedic Alliance PLLC
• Evangelyn Aletheia Spencer, D.M.D.
• Linda Karen Starling, MS
• State of Alabama
• Paul Stevens, DO
• Cheri Nicole Stewart, LPN
• Surgical Associates of South Alabama, PC

• Surgery Physician in Brewton, AL
• Providers in Brewton, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.