Nicholas Wade Stull, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101021742 Issued in MI

Practice address

3421 W 9TH St
Waterloo, IA 50702-5401

Phone

(319) 272-8000

Fax

(319) 272-7313

NPI assigned

Apr 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians

Caberfae Emergency Group PCGroup PAC ID 4082069232, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Manistee Hospital Hospital, Manistee, MI, CCN 230303

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nstull897392@direct.unitypoint.org

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.

• Caberfae Emergency Group, P.C.

  • Emergency Medicine Physician
  • Cadillac, MI
  • NPI 1447932504
  Medicare reassignment Care Compare group NPD
• Interlochen Emergency Group, P.C.

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1336821495
  Medicare reassignment Care Compare group NPD
• Degara App, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1265976971
  Medicare reassignment NPD
• Iowa Emergency Physicians LLP

  • Emergency Medicine Physician
  • Waterloo, IA
  • NPI 1386879427
  NPD
• Iowa Emergency Physicians LLP

  • Emergency Medicine Physician
  • Keokuk, IA
  • NPI 1518354810
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Manistee Hospital

  • General Acute Care Hospital
  • Manistee, MI
  • NPI 1407949191
  Care Compare affiliation

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

{
    "created_epoch": "1429401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1811384704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "231-313-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8000",
            "fax_number": "319-272-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULL",
        "first_name": "NICHOLAS",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-19",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315070508",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonita Streich-Hermanstorfer, LMHC
• Nicole Stroh
• Hannah Noel Strottman, ARNP
• Charlotte Anne Strub, PT
• Katherine Strub, LMHC, M.A, NCC
• Pawina Subedi, MD
• Brittney Ann Suckow, ARNP
• Melissa Gail Sudol
• Jeffrey Anthony Sugandi, M.D.
• Mark Suiter, PT

• Emergency Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Emergency Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.

Verify at the official NPI Registry.