Active NPI
Stephen T McTigue, MD
- Otolaryngology Physician
- South Bend, IN
National Provider Identifier
1619907136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 01031034
- Practice address
- 6301 University Commons
Suite 360
South Bend, IN 46635-1571 - Phone
- (574) 232-4800
- Fax
- (574) 280-4810
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 01031034 | IN | Primary |
Addresses
Primary practice location
6301 University Commons
Suite 360
South Bend, IN 46635-1571
Mailing address
6301 University Commons
Suite 360
South Bend, IN 46635-1571
Phone (574) 232-4800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01031034 | Other | IN | LICENSE |
| 100143290A | Medicaid | IN | |
| 000000085507 | Other | IN | ANTHEM PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Otorhinolaryngology, Inc | Past | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- South Bend, IN
- NPI 1942246822
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- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1619907136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 UNIVERSITY COMMONS",
"address_2": "SUITE 360",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351571",
"telephone_number": "574-232-4800",
"fax_number": "574-280-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 UNIVERSITY COMMONS",
"address_2": "SUITE 360",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351571",
"telephone_number": "574-232-4800",
"fax_number": "574-280-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCTIGUE",
"first_name": "STEPHEN",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "01031034",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "01031034",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100143290A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000085507",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.