Individual provider Active NPI

Stephen Michael Dahlstedt, MD

  • Urology Physician
  • Greensboro, NC
National Provider Identifier
1861487936
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35311 Issued in NC
Practice address
509 N Elam Ave FL 2
Greensboro, NC 27403-1157
Phone
(336) 274-1114
Fax
(336) 232-5325
NPI assigned
Sep 15, 2005
Last updated
Feb 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35311 NC Primary

Addresses

Primary practice location

509 N Elam Ave FL 2
Greensboro, NC 27403-1157

Mailing address

509 N Elam Ave FL 2
Greensboro, NC 27403-1157
Phone (336) 274-1114

Other identifiers 2

IdentifierTypeStateIssuer
8926745MedicaidNC
26745OtherNCBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20031208000998 NC Practitioner - Urology 6305742750 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Virginia Commonwealth University, School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

618 S Main St
Reidsville, NC 27320-5020
Phone (336) 951-6070

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35311NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of the Carolinas PLLC Urology CurrentSince Jul 1, 1992 Accepting new patients
Piedmont Stone Center PLLC Urology CurrentSince Jan 1, 1994 Accepting new patients
Moses Cone Physician Services Inc Current Accepting new patients
Freedom Healthcare Current Accepting new patients
Moses Cone Physician Services, Inc. Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

509 N Elam Ave
Fl 2
Greensboro, NC 27403
Phone (336) 274-1114

401A W Decatur St
Madison, NC 27025
Phone (336) 548-4753

1107 S Main St
Reidsville, NC 27320
Phone (336) 348-6664

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

1907 S Hawthorne Rd
Winston Salem, NC 27103

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1861487936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031157",
            "telephone_number": "336-274-1114",
            "fax_number": "336-232-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031157",
            "telephone_number": "336-274-1114",
            "fax_number": "336-232-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLSTEDT",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "35311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8926745",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "26745",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.