Individual provider Active NPI

Jeannine Marie Stein, MD

  • MOHS-Micrographic Surgery Physician
  • Melbourne, FL
National Provider Identifier
1407811235
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
ME88079 Issued in FL
Practice address
7960 N Wickham Rd
Suite 105
Melbourne, FL 32940
Phone
(321) 428-4545
Fax
(321) 421-7898
NPI assigned
Apr 17, 2006
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X ME88079 FL Primary

Addresses

Primary practice location

7960 N Wickham Rd
Suite 105
Melbourne, FL 32940

Mailing address

8057 Spyglass Hill Rd
Suite 102
Melbourne, FL 32940-8565
Phone (321) 428-4545

Other practice location 1

8057 Spyglass Hill Rd
Suite 102
Melbourne, FL 32940-8565
Phone (321) 428-4545

Other identifiers 1

IdentifierTypeStateIssuer
280413100MedicaidFL

Other names 1

  • Dr. Jeannine Marie Stein-McClatchey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041023000217 FL Practitioner - Dermatology 5799746665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Ohio State University College of Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7960 N Wickham Rd
Suite 105
Melbourne, FL 32940-8096
Phone (321) 428-4545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as individual
Quality
81.88
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision368
Removal of skin lesions1-10
Removal of skin cancer1034
Removal of nail tissue1-10
Skin biopsy21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Skin Cancer Surgery, Inc. Mohs-Micrographic Surgery CurrentSince Oct 6, 2014 Accepting new patients
Osler Medical Inc Past Accepting new patients

Locations

7960 N Wickham Rd
Ste 105
Melbourne, FL 32940
Phone (321) 428-4545

8057 Spyglass Hill Rd
Ste 102
Viera, FL 32940
Phone (321) 428-4545

Interoperability endpoints

  • Direct secure messaging: jeannine.stein.1@9384.direct.athenahealth.com

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

Hospital & facility affiliations 4

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1407811235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8057 SPYGLASS HILL RD",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408565",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 N WICKHAM RD",
            "address_2": "SUITE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8057 Spyglass Hill Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329408565",
            "country_code": "US",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEIN",
        "first_name": "JEANNINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME88079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280413100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNINE",
            "last_name": "STEIN-MCCLATCHEY",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.