Individual provider Active NPI

Stephen William Pournaras III, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Prince Frederick, MD
National Provider Identifier
1700319464
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
D0107745 Issued in MD
Practice address
110 Hospital Rd Ste 201
Prince Frederick, MD 20678-4045
Phone
(410) 535-1343
NPI assigned
Apr 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X D0107745 MD Primary
Orthopaedic Surgery Physician 207X00000X D0107745 MD

Addresses

Primary practice location

110 Hospital Rd Ste 201
Prince Frederick, MD 20678-4045

Mailing address

110 Hospital Rd Ste 201
Prince Frederick, MD 20678-4045
Phone (410) 535-1343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170802000913 NC Order and Referring Only - General SurgeryPractitioner - General Surgery 2163793688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1700319464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 201",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784045",
            "telephone_number": "410-535-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 201",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784045",
            "telephone_number": "410-535-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURNARAS",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-09",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D0107745",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0107745",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.