Individual provider Active NPI

James S Stepanski, DO

  • Family Medicine Physician
  • Waterford, MI
National Provider Identifier
1669462974
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JS010360 Issued in MI
Practice address
4030 W Walton Blvd
Waterford, MI 48329-4174
Phone
(248) 674-0431
Fax
(248) 674-1573
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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 JS010360 MI Primary

Addresses

Primary practice location

4030 W Walton Blvd
Waterford, MI 48329-4174

Mailing address

4030 W Walton Blvd
Waterford, MI 48329-4174
Phone (248) 674-0431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JS010360MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Oakland PastSince Mar 27, 1991 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jamesstepanski@wmpc.allscriptsdirect.net

Organizations & group practices 1

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1669462974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294174",
            "telephone_number": "248-674-0431",
            "fax_number": "248-674-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294174",
            "telephone_number": "248-674-0431",
            "fax_number": "248-674-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANSKI",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JS010360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.