Individual provider Active NPI

Daniel Stucker, M.D.

  • Diagnostic Radiology Physician
  • Mountain View, CA
National Provider Identifier
1376625616
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A66491 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7700
NPI assigned
Oct 19, 2006
Last updated
Dec 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A66491 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051115001060 CA Practitioner - Diagnostic Radiology 4587683933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Missouri, Columbia School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66491CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jan 1, 2008 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jan 1, 2008 Accepting new patients
Camino Medical Group Past Accepting new patients

Locations

20410 Town Center Ln
Ste F150
Cupertino, CA 95014
Phone (408) 523-3460

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

370 Distel Cir
#C40876
Los Altos, CA 94022
Phone (415) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

795 El Camino Real
#1112
Palo Alto, CA 94301

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1376625616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKER",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A66491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.