Paul Michael Stover, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

38944-020 Issued in WI

Practice address

2806 Riverview Dr
Green Bay, WI 54313-6717

Phone

(920) 498-7546

Fax

(920) 569-4129

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in HI

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

Dermatology

Education

University of Iowa, RJ & L Carver College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Island Dermatology LLCGroup PAC ID 7719210459, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Island Dermatology LLC

  • Dermatology Physician
  • Kailua Kona, HI
  • NPI 1497226054
  Medicare reassignment Care Compare group NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  NPD (past)
• Gundersen Lutheran Medical Center, Inc.

  • Community Based Hospice Care Agency
  • La Crosse, WI
  • NPI 1013943893
  NPD (past)
• Gundersen Clinic LTD

  • Clinic/Center
  • Harmony, MN
  • NPI 1548215361
  NPD (past)
• Koru Health and Beauty, LLC

  • Family Nurse Practitioner
  • Kamuela, HI
  • NPI 1962926832
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548264336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-683-5278",
            "fax_number": "920-686-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136717",
            "telephone_number": "920-498-7546",
            "fax_number": "920-569-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "38944-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000817140",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548264336",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00338098",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "38944-020",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Stoeger, RD CD
• Taylor Marlene Stoffel, PA-C
• Vaida M Stoik, MD
• Sarah Marie Stone, APNP
• Bryan James Stoppenbach, PA-C
• Savannah Jane Stpeter
• Hannah Elizabeth Strachan, DDS
• Brandon J Stradel, MD
• Jennifer Strader
• Paul F Strand, LCSW,CADCIII

• Dermatology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.