NPIMap

Individual provider Active NPI

Ted Michael Stampien, M.D.

  • Dermatology Physician
  • Scranton, PA
National Provider Identifier
1508920398
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD-073072L Issued in PA
Practice address
327 N Washington Ave Ste 200
Scranton, PA 18503-1535
Phone
(570) 961-5522
Fax
(570) 207-5579
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD073072L PA
Dermatology Physician 207N00000X MD-073072L PA Primary

Addresses

Primary practice location

327 N Washington Ave Ste 200
Scranton, PA 18503-1535

Mailing address

327 N Washington Ave Ste 200
Scranton, PA 18503-1535
Phone (570) 961-5522

Other practice location 1

103 W Grove St
Clarks Summit, PA 18411-2019
Phone (570) 586-7220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110329000279 PA Practitioner - Dermatology 5698958643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Jefferson Medical College of Thomas Jefferson University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lackawanna Valley Dermatology Associates LimitedGroup PAC ID 2668459066, 18 clinicians

Practice addresses (Care Compare)

327 N Washington Ave
St 200
Scranton, PA 18503-1535
Phone (570) 961-5522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.11 of 100Reported as group
Quality
96.44
Promoting interoperability
100
Improvement activities
40
Cost
67.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1483
Removal or shaving of skin growth87
Skin biopsy295

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-073072LPAMDDermatology Physician
MD073072LPAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lackawanna Valley Dermatology Associates Limited Dermatology CurrentSince Jan 1, 2024 Accepting new patients

Locations

327 N Washington Ave
Ste 200
Scranton, PA 18503
Phone (570) 961-5522

327 N Washington Ave
Scranton, PA 18503
Phone (570) 342-4246

Interoperability endpoints

  • Direct secure messaging: tstampien@lackaderm.medentdirect.com

Organizations & group practices 1

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 10

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699056000000",
    "number": "1508920398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522",
            "fax_number": "570-207-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522",
            "fax_number": "570-207-5579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 W Grove St",
            "address_purpose": "LOCATION",
            "city": "Clarks Summit",
            "state": "PA",
            "postal_code": "184112019",
            "country_code": "US",
            "telephone_number": "570-586-7220",
            "fax_number": "570-586-9294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMPIEN",
        "first_name": "TED",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD073072L",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD-073072L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.