Individual provider Active NPI

Wolfgang Stehr, MD

  • Pediatric Surgery Physician
  • Oakland, CA
National Provider Identifier
1548461346
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
19504 Issued in NV
Practice address
744 52ND St
Suite 4100
Oakland, CA 94609-1810
Phone
(510) 428-3022
Fax
(510) 428-3405
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X C54296 CA
Pediatric Surgery Physician 2086S0120X 19504 NV Primary
Specialist 174400000X C54296 CA
Surgery Physician 208600000X C54296 CA
Pediatric Surgery Physician 2086S0120X MD2016-0814 NM

Addresses

Primary practice location

744 52ND St
Suite 4100
Oakland, CA 94609-1810

Mailing address

744 52ND St
Suite 4100
Oakland, CA 94609-1810
Phone (510) 428-3022

Other practice location 1

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Other practice location 2

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-1111

Other practice location 3

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-7878

Other practice location 4

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4342

Other identifiers 3

IdentifierTypeStateIssuer
19504OtherNVMD NEVADA
12146131OtherNVCAQH
C54296OtherCAMD CALI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20170128000000 NM Practitioner - General SurgeryPractitioner - Pediatric Medicine 2567687098 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C54296CAMDSpecialist
19504NVMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Surgery CurrentSince Jan 17, 2017 Accepting new patients
Unm Medical Group Inc CurrentSince Apr 13, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 17, 2017 Accepting new patients
Unm Medical Group, Inc. CurrentSince Apr 13, 2019 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Unm Medical Group Inc Past Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

201 Cedar St SE
Ste 4600
Albuquerque, NM 87106
Phone (505) 563-6450

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

201 Cedar St SE
Ste 4660
Albuquerque, NM 87106
Phone (505) 563-6530

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: wstehr101620@direct.phs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1548461346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 52ND ST",
            "address_2": "SUITE 4100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091810",
            "telephone_number": "510-428-3022",
            "fax_number": "510-428-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 52ND ST",
            "address_2": "SUITE 4100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091810",
            "telephone_number": "510-428-3022",
            "fax_number": "510-428-3405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432204",
            "country_code": "US",
            "telephone_number": "415-476-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871062719",
            "country_code": "US",
            "telephone_number": "505-272-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-4342",
            "fax_number": "775-982-3982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEHR",
        "first_name": "WOLFGANG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "C54296",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NV",
            "license": "19504",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C54296",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C54296",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NM",
            "license": "MD2016-0814",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD NEVADA",
            "identifier": "19504",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12146131",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD CALI",
            "identifier": "C54296",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1600 Eureka Rd",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956613027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.