Individual provider Active NPI

Laura T Stitle, MD

  • Dermatology Physician
  • Greenwood, IN
National Provider Identifier
1457446247
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01056989A Issued in IN
Practice address
53 South Park Blvd
Greenwood, IN 46143
Phone
(317) 889-7546
Fax
(317) 889-2482
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01056989A IN Primary

Addresses

Primary practice location

53 South Park Blvd
Greenwood, IN 46143

Mailing address

53 South Park Blvd
Greenwood, IN 46143
Phone (317) 889-7546

Other identifiers 3

IdentifierTypeStateIssuer
000000306309OtherINANTHEM
7475840OtherCIGNA
7268449OtherINAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040323000157 IN Practitioner - Dermatology 0143111823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

92 S Park Blvd
Greenwood, IN 46143-8836
Phone (317) 889-7546

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision26
Removal of skin lesions1310
Removal of nail tissue1-10
Removal or shaving of skin growth650
Skin biopsy17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047160INMDDermatology Physician
01056989AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L. J. Buckel MD Inc Current Accepting new patients
Greenwood Dermatology PC Dermatology Current Accepting new patients
Major Hospital Past Accepting new patients

Locations

92 S Park Blvd
Greenwood, IN 46143
Phone (317) 859-6626

53 S Park Blvd
Greenwood, IN 46143
Phone (317) 889-7546

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 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1457446247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SOUTH PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46143",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 SOUTH PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46143",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITLE",
        "first_name": "LAURA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01056989A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000306309",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7475840",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7268449",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.