Individual provider Active NPI

Michael Stivelman, M.D.

  • Anesthesiology Physician
  • Berlin, MD
National Provider Identifier
1659352102
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0043086 Issued in MD
Practice address
9733 Healthway Drive
Atlantic General Hospital
Berlin, MD 21811
Phone
(410) 641-9774
Fax
(410) 641-9622
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0043086 MD Primary

Addresses

Primary practice location

9733 Healthway Drive
Atlantic General Hospital
Berlin, MD 21811

Mailing address

10026 Old Ocean City Blvd
Building One
Berlin, MD 21811-1288
Phone (410) 641-9774

Other identifiers 2

IdentifierTypeStateIssuer
182151200MedicaidMD
050050267OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100918000114 MD Practitioner - Anesthesiology 3173567278 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Anesthesia Ams LLC Anesthesiology CurrentSince Aug 31, 2015 Accepting new patients
Associated Anesthesiology Practice P.a. Anesthesiology PastSince Aug 26, 1992 Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients

Locations

12252 Williams Rd SE
Ste 1
Cumberland, MD 21502
Phone (240) 552-0185

641 S Salisbury Blvd
Salisbury, MD 21801
Phone (410) 341-9002

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1659352102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 OLD OCEAN CITY BLVD",
            "address_2": "BUILDING ONE",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111288",
            "telephone_number": "410-641-9774",
            "fax_number": "410-641-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9733 HEALTHWAY DRIVE",
            "address_2": "ATLANTIC GENERAL HOSPITAL",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-641-9774",
            "fax_number": "410-641-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVELMAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0043086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182151200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050050267",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.