Charles Allen Stillman, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

20A11027 Issued in CA

Practice address

546 E Pine St
Stockton, CA 95204-5525

Phone

(209) 467-1000

Fax

(209) 467-7335

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley MRI and Radiology IncGroup PAC ID 0941470223, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Valley MRI and Radiology Inc

  • Clinic/Center
  • Stockton, CA
  • NPI 1568756096

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD Authorized official
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1508836453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 GLORIA CIR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253559",
            "telephone_number": "650-450-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 E PINE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045525",
            "telephone_number": "209-467-1000",
            "fax_number": "209-467-7335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Ham Ln",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952427501",
            "country_code": "US",
            "telephone_number": "209-366-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILLMAN",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A11027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508836453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa R Stidham
• Stiehl Behavioral Consulting, LLC
• Christine Stiehl, MA, BCBA, LBA
• Megan Michael Stiehr, PA-C
• Jessica Stiffler
• Keyanna Marie Stills Dawson
• Alison M Stingle, PSY.D., LMFT
• Angela Miriam Stingle, M.A.
• Charles Stockert, CPO
• Simone Amanda Stocks

• Diagnostic Radiology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.