Individual provider Active NPI

Micheal D Stephens, M.D.

  • Family Medicine Physician
  • Oswego, NY
National Provider Identifier
1659317980
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
231144 Issued in NY
Practice address
110 W Utica St
Oswego, NY 13126-3057
Phone
(315) 342-2024
Fax
(315) 343-5317
NPI assigned
Jun 22, 2006
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 231144 NY Primary

Addresses

Primary practice location

110 W Utica St
Oswego, NY 13126-3057

Mailing address

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Other identifiers 1

IdentifierTypeStateIssuer
02528756MedicaidNY

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
I20040528000967 NY Practitioner - General PracticePractitioner - Family Practice 7315849031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

110 W Utica St
Oswego, NY 13126-3047
Phone (315) 342-2024

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Care PC Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Oswego Family Physicians PC Current Accepting new patients
Oswego Hospital CurrentSince Jan 1, 2021 Accepting new patients
Covenant Medical Group Family Medicine Past Accepting new patients

Locations

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

110 W Utica St
Oswego, NY 13126
Phone (315) 342-2024

Interoperability endpoints

  • Direct secure messaging: msteph@oswegohealth.medentdirect.com
  • Direct secure messaging: stephem@hiemail.healtheconnections.org

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
ConnextcarePulaski, NY, CCN 331880 Federally qualified health center Corporate Officer Apr 1, 2020
Northern Oswego County Health Services, Inc.Oswego, NY, CCN 331128 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Phoenix, NY, CCN 331135 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331133 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Mexico, NY, CCN 331132 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Fulton, NY, CCN 331138 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331139 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331140 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Mexico, NY, CCN 331142 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Sandy Creek, NY, CCN 331143 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Pulaski, NY, CCN 331141 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Pulaski, NY, CCN 331144 Federally qualified health center Corporate Director Apr 1, 2020
Northern Oswego County Health Services, Inc.Central Square, NY, CCN 571831 Federally qualified health center Corporate Director May 1, 2020
ConnextcareOswego, NY, CCN 571864 Federally qualified health center Corporate Director Apr 1, 2020

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

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

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1659317980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511",
            "fax_number": "315-349-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W UTICA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263057",
            "telephone_number": "315-342-2024",
            "fax_number": "315-343-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MICHEAL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "231144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02528756",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.