NPIMap

Organization Active NPI

Steward Medical Group, Inc

  • Gastroenterology Physician
  • Melbourne, FL
National Provider Identifier
1760149637
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
STEWARD MEDICAL GROUP, INC
Practice address
240 N Wickham Rd Ste 311
Melbourne, FL 32935-8661
Phone
(321) 785-1630
NPI assigned
Nov 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Authorized official

Name
Amy Marie Guay
Title
President of SMG
Phone
(617) 562-7070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

240 N Wickham Rd Ste 311
Melbourne, FL 32935-8661

Mailing address

9 Galen St
Watertown, MA 02472-4515

Other identifiers 1

IdentifierTypeStateIssuer
20669901MedicaidFL

Other names 1

  • 240 N WICKHAM RD, SUITE 311 Other name

National Provider Directory

National Provider Directory
Tax ID family
Compass Medical PC60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637884800000",
    "number": "1760149637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GALEN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N WICKHAM RD STE 311",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358661",
            "telephone_number": "321-785-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWARD MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-26",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "GUAY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT OF SMG",
        "authorized_official_telephone_number": "617-562-7070"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20669901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "240 N WICKHAM RD, SUITE 311",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.