Active NPI
Michael G Stebbins, M.D.
- Diagnostic Radiology Physician
- Princeton, NJ
National Provider Identifier
1619975489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MA04686100
- Practice address
- 41 Governors LN
Princeton, NJ 08540-3670 - Phone
- (609) 921-3579
- NPI assigned
- Jul 14, 2005
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MA04686100 | NJ | Primary |
Addresses
Primary practice location
41 Governors LN
Princeton, NJ 08540-3670
Mailing address
41 Governors LN
Princeton, NJ 08540-3670
Phone (609) 921-3579
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5039304 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of South Florida College of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1245 Whitehorse Mercerville Rd
Suite 403
Hamilton, NJ 08619-3831
Phone (609) 581-2727
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA04686100 | NJ | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burlington Diagnostic Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| Mercer Diagnostic Imaging, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Garden State Magnetic Imaging, P.C. | Past | Accepting new patients | |
| Quakerbridge Radiology Associates PA | Diagnostic Radiology | Past | Accepting new patients |
Locations
2800 Route 130 N
Ste 202
Cinnaminson, NJ 08077
Phone (856) 210-7666
1245 Whitehorse Mercerville Rd
Ste 403
Trenton, NJ 08619
Phone (609) 581-2727
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Hamilton, NJ
- NPI 1841826567
-
- Mammography Clinic/Center
- Cinnaminson, NJ
- NPI 1124616297
Diagnostic Radiology
-
- Radiology Clinic/Center
- Hamilton, NJ
- NPI 1619085990
-
- Diagnostic Radiology Physician
- Mercerville, NJ
- NPI 1124027909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267660800000",
"number": "1619975489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 GOVERNORS LN",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085403670",
"telephone_number": "609-921-3579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 GOVERNORS LN",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085403670",
"telephone_number": "609-921-3579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEBBINS",
"first_name": "MICHAEL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2010-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NJ",
"license": "MA04686100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5039304",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Princeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.