Individual provider Active NPI

Stefan Gary Chevalier, D.O.

  • Plastic Surgery Physician
  • Middletown, NY
National Provider Identifier
1649377094
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
211120 Issued in NY
Practice address
726 E Main St
Suite 201
Middletown, NY 10940-2653
Phone
(845) 703-1225
Fax
(845) 703-4380
NPI assigned
Sep 20, 2006
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 211120 NY Primary

Addresses

Primary practice location

726 E Main St
Suite 201
Middletown, NY 10940-2653

Mailing address

726 E Main St
Suite 201
Middletown, NY 10940-2653
Phone (845) 703-1225

Other identifiers 1

IdentifierTypeStateIssuer
01908070MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080428000513 NY Practitioner - Plastic and Reconstructive Surgery 9739267030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

726 E Main St
Suite 201
Middletown, NY 10940-2654
Phone (845) 703-1225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12
Melanoma (skin cancer) excision39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stefan G. Chevalier, DO, PC Plastic Surgery CurrentSince Feb 24, 2000 Accepting new patients
Loomis Plastic Surgery, PC Plastic Surgery PastSince Nov 11, 2010 Accepting new patients

Locations

726 E Main St
Ste 201
Middletown, NY 10940
Phone (845) 342-1495

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1649377094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402653",
            "telephone_number": "845-703-1225",
            "fax_number": "845-703-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402653",
            "telephone_number": "845-703-1225",
            "fax_number": "845-703-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEVALIER",
        "first_name": "STEFAN",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "211120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01908070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.