NPIMap

Individual provider Active NPI

Mark Alan Stutzman, DO

  • Family Medicine Physician
  • Wooster, OH
National Provider Identifier
1659536761
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34011365 Issued in OH
Practice address
3477 Commerce Pkwy
Suite a
Wooster, OH 44691-7126
Phone
(330) 601-0999
Fax
(330) 601-0935
NPI assigned
Jul 29, 2008
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS015821 PA
Family Medicine Physician 207Q00000X 34011365 OH Primary

Addresses

Primary practice location

3477 Commerce Pkwy
Suite a
Wooster, OH 44691-7126

Mailing address

3477 Commerce Pkwy
Suite a
Wooster, OH 44691-7126
Phone (330) 601-0999

Other identifiers 1

IdentifierTypeStateIssuer
0105072MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.stutzman@42346140532740.direct.elationemr.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140714001436 OH Practitioner - Family Practice 7315110434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buckeye Family Healthcare LLCGroup PAC ID 5890140032, 4 clinicians

Practice addresses (Care Compare)

3477 Commerce Pkwy
Suite a
Wooster, OH 44691-7126
Phone (330) 601-0999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Buckeye Family Healthcare LLC Family Medicine CurrentSince Aug 26, 2023 Accepting new patients

Locations

3477 Commerce Pkwy
Ste A
Wooster, OH 44691
Phone (330) 345-8410

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, 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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1659536761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3477 COMMERCE PKWY",
            "address_2": "SUITE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917126",
            "telephone_number": "330-601-0999",
            "fax_number": "330-601-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3477 COMMERCE PKWY",
            "address_2": "SUITE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917126",
            "telephone_number": "330-601-0999",
            "fax_number": "330-601-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS015821",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34011365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105072",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.stutzman@42346140532740.direct.elationemr.com",
            "affiliation": "N",
            "address_1": "3477 Commerce Pkwy",
            "address_2": "Suite A",
            "city": "Wooster",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446917126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.