Individual provider Active NPI

Larry A Stern, MD

  • Vascular Surgery Physician
  • Wooster, OH
National Provider Identifier
1437151388
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35054753S Issued in OH
Practice address
1685 Cleveland Rd Ste 102
Wooster, OH 44691-2335
Phone
(330) 263-8750
Fax
(330) 263-8752
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35054753S OH
Vascular Surgery Physician 2086S0129X 35054753S OH Primary

Addresses

Primary practice location

1685 Cleveland Rd Ste 102
Wooster, OH 44691-2335

Mailing address

3540 Burbank Rd # 127
Wooster, OH 44691-8539
Phone (330) 465-4429

Other identifiers 6

IdentifierTypeStateIssuer
000000222078OtherANTHEM BC/BS
0167055MedicaidOH
020556806OtherOHWORKERS COMPENSATION
020556806LSOtherSUMMACARE INC
L0167055MedicaidOH
020052952OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070305000352 OH Practitioner - Vascular SurgeryPractitioner - General Surgery 5991760373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Ohio State University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1685 Cleveland Rd
Suite 102
Wooster, OH 44691-2335
Phone (330) 263-8750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue229
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35054753SOHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Specialists of Wayne County, LLC Surgery CurrentSince Mar 18, 2002 Accepting new patients
A Jay Raimonde MD LLC Surgery Past Accepting new patients

Locations

2317 Gateway Dr
Apt C
Wooster, OH 44691
Phone (330) 262-0081

2200 Benden Dr
Ste 8
Wooster, OH 44691
Phone (330) 262-7272

1685 Cleveland Rd
Ste 102
Wooster, OH 44691
Phone (330) 263-8750

3540 Burbank Rd
Wooster, OH 44691
Phone (330) 331-6200

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

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.

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1437151388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 BURBANK RD # 127",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918539",
            "telephone_number": "330-465-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 CLEVELAND RD STE 102",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912335",
            "telephone_number": "330-263-8750",
            "fax_number": "330-263-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "LARRY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35054753S",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35054753S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000222078",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167055",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "020556806",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE INC",
            "identifier": "020556806LS",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L0167055",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020052952",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.