Active NPI
Stephen L Engroff, MD DDS
- Oral and Maxillofacial Surgery (Dentist)
- State College, PA
National Provider Identifier
1366474314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- MD422877
- Practice address
- 200 W Beaver Ave
Suite 100
State College, PA 16801 - Phone
- (814) 238-0587
- Fax
- (814) 238-3840
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | DS035655 | PA | |
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | MD422877 | PA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS035655 | PA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | MD422877 | PA | Primary |
Addresses
Primary practice location
200 W Beaver Ave
Suite 100
State College, PA 16801
Mailing address
200 W Beaver Ave Ste 100
State College, PA 16801-4820
Phone (814) 238-0587
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79677 | Other | GEISINGER HEALTH PLAN | |
| EN1480132 | Other | HIGHMARK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040116000957 | PA | Practitioner - Maxillofacial Surgery | 3577464056 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Maxillofacial Surgery
- Education
- University of Maryland School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri-County Oral-Facial Surgeons PC
Practice addresses (Care Compare)
200 W Beaver Ave
Suite 100
State College, PA 16801-4820
Phone (814) 238-0587
930 Bellefonte Ave
Suite 101
Lock Haven, PA 17745-2749
Phone (570) 893-1702
Hospital & facility affiliations
- Geisinger Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035655 | PA | MD | Oral and Maxillofacial Pathology Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Oral-Facial Surgeons, PLLC | Oral and Maxillofacial Pathology | Current | Accepting new patients |
| Kurowski MD Spine and Pain Management LLC | Past | Accepting new patients |
Locations
930 Bellefonte Ave
Ste 101
Lock Haven, PA 17745
Phone (570) 893-1702
200 W Beaver Ave
Ste 100
State College, PA 16801
Phone (814) 238-0587
211 W Beaver Ave
State College, PA 16801
Phone (814) 238-0587
Organizations & group practices 2
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- State College, PA
- NPI 1265479638
Oral and Maxillofacial Pathology, PA
-
- Interventional Pain Medicine Physician
- Lock Haven, PA
- NPI 1205647963
Hospital & facility affiliations 26
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1366474314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W BEAVER AVE STE 100",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168014820",
"telephone_number": "814-238-0587",
"fax_number": "814-238-3840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W BEAVER AVE",
"address_2": "SUITE 100",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "16801",
"telephone_number": "814-238-0587",
"fax_number": "814-238-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGROFF",
"first_name": "STEPHEN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "PA",
"license": "DS035655",
"primary": false
},
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "PA",
"license": "MD422877",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "DS035655",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "MD422877",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "79677",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "EN1480132",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.