Individual provider Active NPI

Glenn Robert Stehman, DO

  • Cardiovascular Disease Physician
  • Voorhees, NJ
National Provider Identifier
1457419053
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MB03812800 Issued in NJ
Practice address
15 Dutchtown Rd
Voorhees, NJ 08043-9530
Phone
(856) 753-8062
Fax
(856) 753-3241
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MB03812800 NJ Primary

Addresses

Primary practice location

15 Dutchtown Rd
Voorhees, NJ 08043-9530

Mailing address

15 Dutchtown Rd
Voorhees, NJ 08043-9530
Phone (856) 753-8062

Other identifiers 2

IdentifierTypeStateIssuer
101910952MedicaidPA
1973530OtherPAHIGHMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060113000057 NJ Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3577586791

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB03812800NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. Past Accepting new patients
South Sound Inpatient Physicians, PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1457419053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DUTCHTOWN RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439530",
            "telephone_number": "856-753-8062",
            "fax_number": "856-753-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DUTCHTOWN RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439530",
            "telephone_number": "856-753-8062",
            "fax_number": "856-753-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEHMAN",
        "first_name": "GLENN",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MB03812800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101910952",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1973530",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.