Individual provider Active NPI

Stephen L Dickson Jr., MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Topeka, KS
National Provider Identifier
1720086242
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
04-49632 Issued in KS
Practice address
600 SW College Ave
Topeka, KS 66606-1684
Phone
(785) 233-9643
NPI assigned
Jul 8, 2005
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 04-49632 KS Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 43991 KY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01058168A IN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301114501 MI

Addresses

Primary practice location

600 SW College Ave
Topeka, KS 66606-1684

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8172

Other practice location 1

3 Audubon Plaza Dr Ste 1319
Louisville, KY 40217-1319
Phone (502) 636-8004

Other practice location 2

2500 Niles Rd Ste 6
Saint Joseph, MI 49085-3268
Phone (269) 408-1660

Other identifiers 7

IdentifierTypeStateIssuer
000057094VOtherKYHUMANA- CTS
200455130MedicaidIN
4001605OtherKYCIGNA- CTS
50031859OtherKYPASSPORT- CTS
200455130AMedicaidIN
000000701004OtherKYANTHEM- CTS
64076821MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240823000101 KS Practitioner - Thoracic Surgery 7113831843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Miami Medical College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Topeka Physician Group LLCGroup PAC ID 6406112473, 149 clinicians

Practice addresses (Care Compare)

1700 SW 7TH St
Topeka, KS 66606-2489
Phone (785) 295-8108

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-49632KSMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Topeka Physician Group, LLC CurrentSince Jul 15, 2024 Accepting new patients
Topeka Physician Group, LLC CurrentSince Jul 15, 2024 Accepting new patients
Ohio Valley Heartcare Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

1700 SW 7th St
Topeka, KS 66606
Phone (785) 295-5310

600 SW College Ave
Topeka, KS 66606
Phone (785) 233-0292

Interoperability endpoints

  • Direct secure messaging: sdickson@mybeacon.cernerdirect.com
  • Direct secure messaging: sdickson32221@lakeland.midirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1720086242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-983-8172",
            "fax_number": "699-854-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SW COLLEGE AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061684",
            "telephone_number": "785-233-9643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Audubon Plaza Dr Ste 1319",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171319",
            "country_code": "US",
            "telephone_number": "502-636-8004",
            "fax_number": "502-636-8384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Niles Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490853268",
            "country_code": "US",
            "telephone_number": "269-408-1660",
            "fax_number": "269-408-1665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KS",
            "license": "04-49632",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "43991",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01058168A",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301114501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA- CTS",
            "identifier": "000057094V",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200455130",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA- CTS",
            "identifier": "4001605",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT- CTS",
            "identifier": "50031859",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200455130A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM- CTS",
            "identifier": "000000701004",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64076821",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.