Stephen Michael Bane, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

0101055871 Issued in VA

Practice address

2280 Opitz Blvd
Suite 340
Woodbridge, VA 22191-3362

Phone

(703) 878-0777

Fax

(703) 583-1777

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Capitol Breathe Free Sinus & Allergy Centers

  • Otolaryngology Physician
  • Washington, DC
  • NPI 1801374228
  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1528046349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 JEFFERSON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223144323",
            "telephone_number": "703-878-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 OPITZ BLVD",
            "address_2": "SUITE 340",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913362",
            "telephone_number": "703-878-0777",
            "fax_number": "703-583-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2070 Old Bridge Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lake Ridge",
            "state": "VA",
            "postal_code": "221922495",
            "country_code": "US",
            "telephone_number": "703-499-8787",
            "fax_number": "703-499-8222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6371 Little River Tpke Fl 1",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223125002",
            "country_code": "US",
            "telephone_number": "571-351-4850",
            "fax_number": "703-499-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANE",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101055871",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "VA",
            "license": "0101055871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6500226",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.