Individual provider Active NPI

Stephen K Richardson, MD

  • Dermatology Physician
  • Tallahassee, FL
National Provider Identifier
1710918404
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME98820 Issued in FL
Practice address
1714 Mahan Center Blvd
Tallahassee, FL 32308-5427
Phone
(850) 877-4134
Fax
(850) 402-9130
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME98820 FL Primary

Addresses

Primary practice location

1714 Mahan Center Blvd
Tallahassee, FL 32308-5427

Mailing address

PO Box 13834
Tallahassee, FL 32317-3834
Phone (850) 877-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070922000252 FL Practitioner - Dermatology 6103821186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Tallahassee PAGroup PAC ID 6608775499, 39 clinicians

Practice addresses (Care Compare)

1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone (850) 877-4134

Hospital & facility affiliations

  • Doctors Memorial Hospital Inc Hospital, Perry, FL, CCN 101314

Merit-based Incentive Payment System (MIPS)

Final score
89.59 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
72.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision144
Removal of skin lesions1859
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy897

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME98820FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Tallahassee PA Dermatology CurrentSince Jun 1, 2007 Accepting new patients
Dermatology Associates of Tallahassee, PA Dermatology CurrentSince Jun 1, 2007 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

19611 State Road 20 W
Blountstown, FL 32424
Phone (850) 674-5645

1707 Riggins Rd
Tallahassee, FL 32308
Phone (850) 205-6232

1714 Mahan Center Blvd
Tallahassee, FL 32308
Phone (850) 205-6232

Interoperability endpoints

  • Direct secure messaging: skrichardson@dat1977.srs-direct.com
  • Direct secure messaging: srichardson@dermse.emadirect.md

Organizations & group practices 3

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 1

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1710918404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13834",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173834",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 MAHAN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085427",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "STEPHEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME98820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.