Active NPI
Daniel A Stephens, MD
- Surgery Physician
- Saint Joseph, MI
National Provider Identifier
1831127463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301404254
- Practice address
- 3950 Hollywood Rd
Suite 100
Saint Joseph, MI 49085-9151 - Phone
- (269) 429-0900
- Fax
- (269) 408-0996
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301404254 | MI | Primary |
Addresses
Primary practice location
3950 Hollywood Rd
Suite 100
Saint Joseph, MI 49085-9151
Mailing address
3950 Hollywood Road
Suite 100
St Joseph, MI 49085
Phone (269) 429-0900
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27-0381199 | Other | MI | GROUP TAX ID |
| 1538397120 | Other | MI | GROUP NPI |
| 0201109862 | Other | MI | BLUE CROSS PIN |
| 1831127463 | Medicaid | MI | |
| MI2051 | Other | MI | GROUP MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Medical Clinic PC | Past | Accepting new patients | |
| Lakeland Medical Practices | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Urology Physician
- Niles, MI
- NPI 1932493863
-
- Specialist
- Niles, MI
- NPI 1518022144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1831127463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3950 HOLLYWOOD ROAD",
"address_2": "SUITE 100",
"city": "ST JOSEPH",
"state": "MI",
"postal_code": "49085",
"telephone_number": "269-429-0900",
"fax_number": "269-408-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3950 HOLLYWOOD RD",
"address_2": "SUITE 100",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490859151",
"telephone_number": "269-429-0900",
"fax_number": "269-408-0996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "DANIEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301404254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP TAX ID",
"identifier": "27-0381199",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1538397120",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PIN",
"identifier": "0201109862",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1831127463",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE PTAN",
"identifier": "MI2051",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.