NPIMap

Organization Active NPI

Steward Medical Group Inc.

  • Internal Medicine Physician
  • Brookfield, OH
National Provider Identifier
1902347438
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STEWARD MEDICAL GROUP INC.
Practice address
7264 Warren Sharon Rd
Brookfield, OH 44403-9691
Phone
(615) 467-4158
Fax
(615) 467-1267
NPI assigned
Mar 16, 2017
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Ashley Koch
Title
Cfo
Phone
(617) 562-5359

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Interventional Cardiology Physician 207RI0011X NU
Infectious Disease Physician 207RI0200X NU
Pulmonary Disease Physician 207RP1001X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Surgery Physician 208600000X NU
Surgical Oncology Physician 2086X0206X NU

Addresses

Primary practice location

7264 Warren Sharon Rd
Brookfield, OH 44403-9691

Mailing address

9 Galen St
Watertown, MA 02472-4515
Phone (617) 562-5359

Other names 1

  • SMG VCS Region Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170515002104 OH Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 87 practitioners
1 other NPI on this enrollment
Practice locations: Youngstown, OH; Warren, OH; Hubbard, OH; Austintown, OH; Boardman, OH; Canfield, OH; Cortland, OH; Brookfield, OH
O20170524000169 PA Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 179 practitioners
3 other NPIs on this enrollment
Practice locations: Hermitage, PA; Easton, PA; Holland, PA; Meadville, PA; Mercer, PA; New Castle, PA; Sharon, PA; Wind Gap, PA…

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Steward Physician Network Inc60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

9 Galen St
Ste 130
Watertown, MA 02472

4135 Boardman Canfield Rd
Ste 202
Canfield, OH 44406
Phone (330) 967-4660

2668 Elm Rd NE
Cortland, OH 44410
Phone (330) 841-1070

55 Hall Ave
Hubbard, OH 44425
Phone (330) 534-1978

8747 Squires Ln NE
Warren, OH 44484
Phone (330) 841-3607

1800 Sullivan Trl
Easton, PA 18040
Phone (610) 250-8799

1800 Sullivan Trl
Ste 320
Easton, PA 18040
Phone (610) 419-6525

2005 Fairview Ave
Ste B
Easton, PA 18042
Phone (610) 258-3615

2111 Washington Blvd
Fl 1
Easton, PA 18042
Phone (610) 250-4595

2395 Garden Way
Sharon, PA 16148
Phone (724) 342-5890

Practitioners & affiliated clinicians

Practitioners 237

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 237

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1902347438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GALEN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724515",
            "telephone_number": "617-562-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7264 WARREN SHARON RD",
            "city": "BROOKFIELD",
            "state": "OH",
            "postal_code": "444039691",
            "telephone_number": "615-467-4158",
            "fax_number": "615-467-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWARD MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-562-5359"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMG VCS Region",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SMG VCS Region",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brookfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.