Active NPI
Theodore Steve Stamatakos, M.D.
- Urology Physician
- Keene, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- EL09256
- Practice address
- 590 Court St
Keene, NH 03431-1719 - Phone
- (603) 354-5400
- Fax
- (603) 354-5400
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | LT4309 | NH | |
| Urology Physician | 208800000X | 200000981 | NC | |
| Urology Physician | 208800000X | EL09256 | NH | Primary |
Addresses
Primary practice location
590 Court St
Keene, NH 03431-1719
Mailing address
590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, SC, NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- New York Medical College, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172
Hospital & facility affiliations
- Scotland Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12107 | SC | MD | Pharmacist |
| LT4309 | NH | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheshire Medical Center | Current | Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Current | Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients | |
| Cheshire Medical Center | Current | Accepting new patients | |
| Providence Urology, PLLC | Specialist | Past | Accepting new patients |
Locations
580 Court St
Keene, NH 03431
Phone (603) 354-5454
590 Court St
Keene, NH 03431
Phone (603) 354-5454
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
Interoperability endpoints
- tstamatakos537587@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 7
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.
-
- Vascular Surgery Physician
- Laurinburg, NC
- NPI 1477791507
-
- Emergency Medicine Physician
- Keene, NH
- NPI 1093803397
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
-
- Family Medicine Physician
- Keene, NH
- NPI 1306349444
-
- Community/Retail Pharmacy
- Keene, NH
- NPI 1033761739
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Laurinburg, NC
- NPI 1457345597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1720007099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5400",
"fax_number": "704-414-2860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5400",
"fax_number": "603-354-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAMATAKOS",
"first_name": "THEODORE",
"middle_name": "STEVE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2022-06-16",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NH",
"license": "LT4309",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NC",
"license": "200000981",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NH",
"license": "EL09256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Keene, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.