Individual provider Active NPI

Eric David Stamps, D.P.M.

  • Podiatrist
  • Mill Valley, CA
National Provider Identifier
1417962101
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3973 Issued in CA
Practice address
203 E Blithedale Ave
Suite B
Mill Valley, CA 94941-2046
Phone
(415) 381-0330
Fax
(415) 381-5319
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3973 CA Primary

Addresses

Primary practice location

203 E Blithedale Ave
Suite B
Mill Valley, CA 94941-2046

Mailing address

203 E Blithedale Ave
Suite B
Mill Valley, CA 94941-2046
Phone (415) 381-0330

Other identifiers 1

IdentifierTypeStateIssuer
000E39731MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223000241 CA Practitioner - Podiatry 0345421459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City and County of San FranciscoGroup PAC ID 1658280748, 368 clinicians

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (415) 206-2305

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
61.12
Promoting interoperability
99
Improvement activities
40
Cost
83.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue125
Removal or shaving of skin growth41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3973CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
City & County of San Francisco Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 19, 2010 Accepting new patients
City and County of San Francisco CurrentSince Aug 27, 2024 Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 19, 2010 Accepting new patients
City & County of San Francisco CurrentSince Aug 27, 2024 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1050 Wisconsin St
San Francisco, CA 94107
Phone (415) 648-3022

375 Laguna Honda Blvd
San Francisco, CA 94116
Phone (415) 759-2300

3850 17th St
San Francisco, CA 94114
Phone (415) 487-7500

1525 Silver Ave
San Francisco, CA 94134
Phone (415) 657-1700

2401 Keith St
San Francisco, CA 94124
Phone (415) 671-7000

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 6

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 2

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1417962101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E BLITHEDALE AVE",
            "address_2": "SUITE B",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412046",
            "telephone_number": "415-381-0330",
            "fax_number": "415-381-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E BLITHEDALE AVE",
            "address_2": "SUITE B",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412046",
            "telephone_number": "415-381-0330",
            "fax_number": "415-381-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMPS",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E39731",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Road",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.