Individual provider Active NPI

Stefanie Alida Schultis, M.D.

  • Specialist
  • Covington, LA
National Provider Identifier
1528065521
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
018419 Issued in LA
Practice address
110 Lakeview Dr
Suite 100
Covington, LA 70433-7509
Phone
(985) 898-1940
Fax
(985) 893-3427
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 018419 LA Primary

Addresses

Primary practice location

110 Lakeview Dr
Suite 100
Covington, LA 70433-7509

Mailing address

110 Lakeview Dr
Suite 100
Covington, LA 70433-7509
Phone (985) 898-1940

Other identifiers 2

IdentifierTypeStateIssuer
1389579MedicaidLA
721166765OtherLATAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20050223000833 LA Practitioner - Obstetrics/Gynecology 4587614912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tulane University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Lakeview Dr
Suite 100
Covington, LA 70433-7511
Phone (985) 898-1940

Hospital & facility affiliations

  • St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045
  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • Avala Hospital, Covington, LA, CCN 190267
  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018419LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Stefanie a. Schultis, M.D., a.P.M.C. Specialist CurrentSince Nov 14, 2008 Accepting new patients

Locations

110 Lakeview Dr
Ste 100
Covington, LA 70433
Phone (985) 892-4544

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1528065521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LAKEVIEW DR",
            "address_2": "SUITE 100",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337509",
            "telephone_number": "985-898-1940",
            "fax_number": "985-893-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LAKEVIEW DR",
            "address_2": "SUITE 100",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337509",
            "telephone_number": "985-898-1940",
            "fax_number": "985-893-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTIS",
        "first_name": "STEFANIE",
        "middle_name": "ALIDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "018419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1389579",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "721166765",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.