Individual provider Active NPI

Warren C Stout, M.D.

  • Ophthalmology Physician
  • Pasadena, CA
National Provider Identifier
1790829208
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G46809 Issued in CA
Practice address
800 E. Colorado Blvd.
Suite 260
Pasadena, CA 91101
Phone
(626) 449-6494
Fax
(626) 449-0813
NPI assigned
Feb 16, 2007
Last updated
Feb 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G46809 CA Primary

Addresses

Primary practice location

800 E. Colorado Blvd.
Suite 260
Pasadena, CA 91101

Mailing address

800 E. Colorado Blvd.
Suite 260
Pasadena, CA 91101
Phone (626) 449-6494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120213000031 CA Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 3779689625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
Southern Illinois University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren C Stout MD a Medical CorpGroup PAC ID 9234235185, 2 clinicians

Practice addresses (Care Compare)

800 E Colorado Blvd
Pasadena, CA 91101-5412
Phone (626) 449-6494

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G46809CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warren C Stout MD a Medical Corp Ophthalmology CurrentSince Jan 1, 1989 Accepting new patients
Laser & Ambulatory Surg Ctr of Pasa Past Accepting new patients

Locations

800 E Colorado Blvd
Ste 260
Pasadena, CA 91101
Phone (626) 449-6494

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1790829208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E. COLORADO BLVD.",
            "address_2": "SUITE 260",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91101",
            "telephone_number": "626-449-6494",
            "fax_number": "626-449-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E. COLORADO BLVD.",
            "address_2": "SUITE 260",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91101",
            "telephone_number": "626-449-6494",
            "fax_number": "626-449-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "WARREN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G46809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.