Individual provider Active NPI

Laurence Stolzenberg, DO, M.SC.

  • Student in an Organized Health Care Education/Training Program
  • Sandusky, OH
National Provider Identifier
1689434342
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
58.034008 Issued in OH
Practice address
1111 Hayes Ave
Sandusky, OH 44870-3323
Phone
(419) 515-5281
NPI assigned
Mar 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.034008 OH Primary

Addresses

Primary practice location

1111 Hayes Ave
Sandusky, OH 44870-3323

Mailing address

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241010001728 OH Order and Referring Only - Interventional RadiologyPractitioner - Interventional Radiology 9931631389

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.034008OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1689434342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-515-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLZENBERG",
        "first_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "DO, M.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.034008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.