NPIMap

Individual provider Active NPI

Shawn Glenn Stern, DO

  • Internal Medicine Physician
  • Wheeling, WV
National Provider Identifier
1558379123
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1768 Issued in WV
Practice address
1 Medical Park
Suite 702
Wheeling, WV 26003
Phone
(304) 243-8409
Fax
(304) 243-8804
NPI assigned
Aug 3, 2006
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1768 WV Primary

Addresses

Primary practice location

1 Medical Park
Suite 702
Wheeling, WV 26003

Mailing address

1 Medical Park
Suite 702
Wheeling, WV 26003
Phone (304) 243-8409

Other identifiers 3

IdentifierTypeStateIssuer
2214197MedicaidOH
1805687000MedicaidWV
110214253OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20080505000535 WV Practitioner - Internal Medicine 9032298898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

40 Medical Park
Suite 501
Wheeling, WV 26003-6392
Phone (304) 243-6390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1768WVMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Nov 4, 2013 Accepting new patients
Wheeling Hospital Inc Past Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients

Locations

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

1 Medical Park
Ste 702
Wheeling, WV 26003
Phone (304) 243-2945

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

40 Medical Park
Ste 501
Wheeling, WV 26003
Phone (304) 242-4182

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1558379123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 702",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-8409",
            "fax_number": "304-243-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 702",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-8409",
            "fax_number": "304-243-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "SHAWN",
        "middle_name": "GLENN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "1768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2214197",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1805687000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110214253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.