Individual provider Active NPI

Melvin Richard Stjernholm, D.O.

  • Surgery Physician
  • Canton, OH
National Provider Identifier
1881802650
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
58-002110 Issued in OH
Practice address
2600 Tuscarawas St W Ste 620
Canton, OH 44708-4676
Phone
(330) 455-8000
Fax
(330) 455-6006
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 58-002110 OH Primary

Addresses

Primary practice location

2600 Tuscarawas St W Ste 620
Canton, OH 44708-4676

Mailing address

2600 Tuscarawas St W Ste 620
Canton, OH 44708-4676
Phone (330) 455-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Rick.stjernholm@direct.aultman.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2600 Tuscarawas St W
Suite 620
Canton, OH 44708-4676

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
77.5
Promoting interoperability
98
Improvement activities
40
Cost
74.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)19
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58-002110OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Specialty Physicians Corporation CurrentSince Feb 14, 2022 Accepting new patients
Aultman Hospital Current Accepting new patients
Ohio Specialty Physicians Corporation Surgery CurrentSince Feb 14, 2022 Accepting new patients

Locations

270 E State St
Ste 120
Alliance, OH 44601
Phone (330) 453-4300

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 Tuscarawas St W
Ste 520
Canton, OH 44708
Phone (330) 454-0702

2600 Tuscarawas St W
Ste 620
Canton, OH 44708
Phone (330) 455-8000

2051 Wales Ave NW
Massillon, OH 44646
Phone (330) 363-7462

Interoperability endpoints

  • Direct secure messaging: rick.stjernholm@direct.aultman.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1881802650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W STE 620",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084676",
            "telephone_number": "330-455-8000",
            "fax_number": "330-455-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W STE 620",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084676",
            "telephone_number": "330-455-8000",
            "fax_number": "330-455-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STJERNHOLM",
        "first_name": "MELVIN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "58-002110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rick.stjernholm@direct.aultman.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2600 Tuscarawas St W Ste 620",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447084676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.