Individual provider Active NPI

Kenneth P Stumpf, D.P.M.

  • Podiatrist
  • Indianapolis, IN
National Provider Identifier
1629208103
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
41000235A Issued in IN
Practice address
6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805
Phone
(317) 621-7584
Fax
(317) 574-5185
NPI assigned
Jul 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 07001125A IN
Podiatrist 213E00000X 41000235A IN Primary

Addresses

Primary practice location

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805

Mailing address

3077 E 98TH St
Ste 100
Indianapolis, IN 46280-2940
Phone (317) 843-2613

Other identifiers 4

IdentifierTypeStateIssuer
768265OtherINBCBS
P01405428OtherINRAILROAD MEDICARE
201082910MedicaidIN
9348862OtherINAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstumpf31182@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120625000396 IN Practitioner - Podiatry 8325203318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westfield Foot and Ankle LLCGroup PAC ID 4587731237, 2 clinicians

Practice addresses (Care Compare)

16411 Southpark Dr
Suite B
Westfield, IN 46074-8469
Phone (317) 896-6655

Hospital & facility affiliations

  • Riverview Health Hospital, Noblesville, IN, CCN 150059
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue334
Removal or shaving of skin growth177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41000235AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Nov 4, 2014 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 4, 2014 Accepting new patients
Westfield Foot and Ankle, LLC Podiatrist CurrentSince Aug 1, 2023 Accepting new patients
Indianapolis Osteopathic Hospital Inc. Podiatrist Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

3077 E 98th St
Ste 100
Carmel, IN 46280
Phone (317) 843-2613

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

16411 Southpark Dr
Ste B
Westfield, IN 46074
Phone (317) 896-6655

Interoperability endpoints

  • Direct secure messaging: kstumpf31182@ecommunitydirect.com

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.

Hospital & facility affiliations 3

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1629208103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 E 98TH ST",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802940",
            "telephone_number": "317-843-2613",
            "fax_number": "317-574-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805",
            "telephone_number": "317-621-7584",
            "fax_number": "317-574-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMPF",
        "first_name": "KENNETH",
        "middle_name": "P",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001125A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "41000235A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "768265",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01405428",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201082910",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9348862",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstumpf31182@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "6626 E 75th St",
            "address_2": "Ste 500",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.