Individual provider Active NPI

Campbell L Stewart, M.D.

  • Dermatopathology Physician
  • Farmington, CT
National Provider Identifier
1750515565
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
061363 Issued in CT
Practice address
21 South Road
Farmington, CT 06032
Phone
(860) 679-4600
Fax
(860) 679-3207
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 061363 CT Primary
Dermatology Physician 207N00000X MD60454651 WA
Dermatopathology Physician 207ND0900X MD60454651 WA

Addresses

Primary practice location

21 South Road
Farmington, CT 06032

Mailing address

21 South Road
Farmington, CT 06032
Phone (860) 679-4600

Other practice location 1

263 Farmington Avenue
Farmington, CT 06030
Phone (860) 679-4600

Other identifiers 2

IdentifierTypeStateIssuer
MD60454651OtherWALICENSE
50D0966896OtherWACLIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cstewart31276@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180806002688 CT Practitioner - Dermatology 1951529015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Vermont College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Connecticut Health CenterGroup PAC ID 3678472016, 624 clinicians

Practice addresses (Care Compare)

21 S Rd
Farmington, CT 06032-2482
Phone (860) 679-4600

Hospital & facility affiliations

  • John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions211
Removal or shaving of skin growth1-10
Skin biopsy99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
061363CTMDDermatopathology Physician
MD60454651WAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Aug 17, 2018 Accepting new patients
University of Connecticut Health Center Dermatology CurrentSince Aug 17, 2018 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

21 South Rd
Farmington, CT 06032
Phone (860) 679-4600

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

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 2

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1750515565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SOUTH ROAD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SOUTH ROAD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-3207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-3207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CAMPBELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CT",
            "license": "061363",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60454651",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD60454651",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD60454651",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "50D0966896",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstewart31276@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.