Individual provider Active NPI

Michael W Stogsdill, PA-C

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1871573352
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50001633 Issued in OH
Practice address
5538 Philadelphia Dr
Dayton, OH 45415-3062
Phone
(937) 424-3589
NPI assigned
Jan 19, 2006
Last updated
Jun 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50001633 OH Primary

Addresses

Primary practice location

5538 Philadelphia Dr
Dayton, OH 45415-3062

Mailing address

3751 Corkwood Dr
Dayton, OH 45424-4925
Phone (937) 236-1636

Other identifiers 1

IdentifierTypeStateIssuer
0083635MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130710000834 OH Practitioner - Physician Assistant 1254571482 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001633OHMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bxl4782i@yourcarecommunity.org

Organizations & group practices 3

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1871573352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 CORKWOOD DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454244925",
            "telephone_number": "937-236-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5538 PHILADELPHIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153062",
            "telephone_number": "937-424-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOGSDILL",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083635",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.