Individual provider Active NPI

Michael Eric Stitzer, M.D.

  • Neurology Physician
  • Winslow, AZ
National Provider Identifier
1588825152
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
46374 Issued in AZ
Practice address
500 North Indiana Ave
Winslow, AZ 86047-2169
Phone
(928) 289-4646
Fax
(928) 289-6289
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 46374 AZ Primary

Addresses

Primary practice location

500 North Indiana Ave
Winslow, AZ 86047-2169

Mailing address

500 North Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120612000022 TX Practitioner - Neurology 6709040397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Icahn School of Medicine at Mount Sinai, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46374AZMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dilkon Medical Center CurrentSince Jan 28, 2013 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Jan 28, 2013 Accepting new patients
Winslow Indian Health Care Center, Inc Current Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1588825152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NORTH INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646",
            "fax_number": "928-289-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTH INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646",
            "fax_number": "928-289-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITZER",
        "first_name": "MICHAEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "46374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.