Individual provider Active NPI

Kieran C. Stober, M.D.

  • Hematology & Oncology Physician
  • Marrero, LA
National Provider Identifier
1679865562
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD.207339 Issued in LA
Practice address
4513 Westbank Expy
Marrero, LA 70072-3120
Phone
(504) 349-6360
Fax
(504) 349-6363
NPI assigned
May 10, 2011
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207339 LA
Hematology & Oncology Physician 207RH0003X MD.207339 LA Primary

Addresses

Primary practice location

4513 Westbank Expy
Marrero, LA 70072-3120

Mailing address

1101 Medical Center Blvd.
Marrero, LA 70072
Phone (504) 349-1656

Other practice location 1

1101 Medical Center Blvd.
Marrero, LA 70072
Phone (504) 349-1656

Other names 1

  • Dr. KC Stober Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20150602001593 LA Practitioner - Internal Medicine 7517288681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Orleans Physician Services IncGroup PAC ID 5294057824, 177 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone (504) 349-2427

1101 Medical Ctr Blvd ER
Marrero, LA 70072-3147
Phone (504) 349-1533

4513 Westbank Expressway
Marrero, LA 70072
Phone (504) 349-6360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
68.02
Improvement activities
40
Cost
76.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207339LAMDInternal Medicine Physician
MD.207339LAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Orleans Physician Services Inc Internal Medicine CurrentSince Jul 6, 2015 Accepting new patients
Culicchia Neurological Clinic, LLC Past Accepting new patients

Locations

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

4513 Westbank Expy
Marrero, LA 70072
Phone (504) 349-6360

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 9

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": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1679865562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD.",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-1656",
            "fax_number": "504-349-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 WESTBANK EXPY",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723120",
            "telephone_number": "504-349-6360",
            "fax_number": "504-349-6363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Medical Center Blvd.",
            "address_purpose": "LOCATION",
            "city": "Marrero",
            "state": "LA",
            "postal_code": "70072",
            "country_code": "US",
            "telephone_number": "504-349-1656",
            "fax_number": "504-349-1933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOBER",
        "first_name": "KIERAN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "207339",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "MD.207339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KC",
            "last_name": "STOBER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.