Individual provider Active NPI

Gary R Stern, MD

  • Cardiovascular Disease Physician
  • Jesup, GA
National Provider Identifier
1700812633
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
072453 Issued in GA
Practice address
111 Colonial Way
Jesup, GA 31545-0130
Phone
(912) 427-8177
Fax
(912) 427-8365
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 174275 NY
Cardiovascular Disease Physician 207RC0000X 072453 GA Primary

Addresses

Primary practice location

111 Colonial Way
Jesup, GA 31545-0130

Mailing address

320 Peachtree St
Jesup, GA 31545-0244
Phone (912) 427-7790

Other identifiers 3

IdentifierTypeStateIssuer
003150982AMedicaidGA
P00272416OtherNYCHS RAILROAD MEDICARE
01420593MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141015002145 GA Practitioner - Cardiovascular Disease (Cardiology) 4789603176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Maryland School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne SJC Medical Group LLCGroup PAC ID 5496901811, 10 clinicians

Practice addresses (Care Compare)

125 Memorial Dr
Jesup, GA 31545-0124
Phone (912) 427-7790

865 S 1St St
Jesup, GA 31545-0210

930 S 1St St
Jesup, GA 31545-0202
Phone (912) 427-7790

Hospital & facility affiliations

  • Wayne Memorial Hospital Hospital, Jesup, GA, CCN 110124
  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
072453GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Wayne County Georgia CurrentSince Dec 1, 2014 Accepting new patients
Wayne SJC Medical Group, LLC Cardiovascular Disease CurrentSince Oct 6, 2014 Accepting new patients
Hospital Authority of Wayne County Georgia Cardiovascular Disease CurrentSince Dec 1, 2014 Accepting new patients
Wayne SJC Medical Group, LLC CurrentSince Oct 6, 2014 Accepting new patients
Mobile Diagnostic Testing Services Inc Past Accepting new patients
Hospital Authority of Wayne County Georgia Past Accepting new patients

Locations

125 Memorial Dr
Ste B
Jesup, GA 31545

865 N 1St St
Jesup, GA 31545
Phone (912) 427-6811

111 Colonial Way
Ste 3
Jesup, GA 31545
Phone (912) 427-8365

320 Peachtree St
Jesup, GA 31545
Phone (912) 521-8039

930 S 1st St
Jesup, GA 31545
Phone (912) 385-2702

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA
  • Direct secure messaging: gary.stern@waynesjc.eclinicaldirectplus.com

Organizations & group practices 6

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.

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1700812633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450244",
            "telephone_number": "912-427-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLONIAL WAY",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450130",
            "telephone_number": "912-427-8177",
            "fax_number": "912-427-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "174275",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "072453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003150982A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHS RAILROAD MEDICARE",
            "identifier": "P00272416",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420593",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

Verify at the official NPI Registry.