NPIMap

Individual provider Active NPI

Stephen James Mittelstaedt, M.D.

  • Surgery Physician
  • Seneca, SC
National Provider Identifier
1407875719
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33135 Issued in SC
Practice address
103 Omni Dr Ste B
Seneca, SC 29672-9448
Phone
(864) 886-9250
Fax
(864) 886-9251
NPI assigned
Jul 18, 2006
Last updated
Feb 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33135 SC Primary

Addresses

Primary practice location

103 Omni Dr Ste B
Seneca, SC 29672-9448

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6303

Other practice location 1

701 Grove Rd
Greenville, SC 29605-5611
Phone (864) 455-7000

Other identifiers 1

IdentifierTypeStateIssuer
331359MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000483 SC Practitioner - General Surgery 1951579515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical University of South Carolina College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

340 Medical Pkwy
Suite 200
Greer, SC 29650-2441
Phone (864) 797-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy38
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 26, 2011 Accepting new patients
Greenville Health System CurrentSince Oct 3, 2011 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Greenville Health System Current Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

340 Medical Pkwy
#200
Greer, SC 29650
Phone (864) 797-7940

103 Omni Dr
#B
Seneca, SC 29672
Phone (864) 482-3285

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

1413 John B White SR Blvd
Ste D
Spartanburg, SC 29306
Phone (864) 587-5768

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: smittelstaedt5643@direct.ghs.myhfn.org

Organizations & group practices 4

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 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1407875719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OMNI DR STE B",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729448",
            "telephone_number": "864-886-9250",
            "fax_number": "864-886-9251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055611",
            "country_code": "US",
            "telephone_number": "864-455-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTELSTAEDT",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "33135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331359",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.