NPIMap

Individual provider Active NPI

Samantha Jo Stiff, MD

  • Family Medicine Physician
  • Dixon, IL
National Provider Identifier
1437687027
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125070548 Issued in IL
Practice address
102 S Hennepin Ave
Dixon, IL 61021-3013
Phone
(815) 285-8520
Fax
(815) 285-8903
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125070548 IL Primary

Addresses

Primary practice location

102 S Hennepin Ave
Dixon, IL 61021-3013

Mailing address

102 S Hennepin Ave
Dixon, IL 61021-3013
Phone (815) 285-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20201026000117 WI Practitioner - Family Practice 3173943578 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

1881 County Rd XX
Kronenwetter, WI 54455-7933
Phone (715) 355-4040

333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone (715) 847-2505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125070548ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 5, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. Family Medicine CurrentSince Oct 5, 2020 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince May 4, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince May 4, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1881 County Road XX
Kronenwetter, WI 54455
Phone (715) 355-4040

333 Pine Ridge Blvd
Ste 185
Wausau, WI 54401
Phone (715) 847-0477

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: sstiff156742@direct.aspirus.org

Organizations & group practices 10

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 11

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437687027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213013",
            "telephone_number": "815-285-8520",
            "fax_number": "815-285-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213013",
            "telephone_number": "815-285-8520",
            "fax_number": "815-285-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIFF",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125070548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.