Active NPI
Stevan I Himmelstein, MD
- Interventional Cardiology Physician
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 20638
- Practice address
- 1211 Union Ave Ste 965
Memphis, TN 38104 - Phone
- (901) 435-8550
- Fax
- (901) 516-0933
- NPI assigned
- Dec 27, 2005
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 12664 | MS | |
| Cardiovascular Disease Physician | 207RC0000X | 20638 | TN | |
| Interventional Cardiology Physician | 207RI0011X | 12664 | MS | |
| Interventional Cardiology Physician | 207RI0011X | 20638 | TN | Primary |
Addresses
Primary practice location
1211 Union Ave Ste 965
Memphis, TN 38104
Mailing address
P O Box 1000 Dept 960
Memphis, TN 38148-0001
Phone (901) 435-8550
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117357001 | Medicaid | AR | |
| 6092182 | Other | TN | BCBS |
| 00115478 | Medicaid | MS | |
| 3807173 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12664 | MS | MD | Interventional Cardiology Physician |
| 20638 | TN | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutherland Cardiology Clinic, P.C. | Current | Accepting new patients | |
| Stern Cardiovascular Center, PA | Cardiovascular Disease | Current | Accepting new patients |
| Memphis Heart Clinic | Cardiovascular Disease | Past | Accepting new patients |
Locations
200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631
7362 Southcrest Pkwy
Southaven, MS 38671
Phone 90127110002272
8060 Wolf River Blvd
Memphis, TN 38138
Phone (901) 271-2272
7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792
6025 Walnut Grove Rd
Ste 111
Memphis, TN 38120
Phone (901) 226-2000
6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190
Interoperability endpoints
- stevanhimmelstein@sccpc.allscriptsdirect.net
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.
-
- Cardiovascular Disease Physician
- Germantown, TN
- NPI 1699790311
-
- Specialist
- Germantown, TN
- NPI 1740391804
-
- Cardiovascular Disease Physician
- Memphis, TN
- NPI 1548235104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1902883481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 1000 DEPT 960",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381480001",
"telephone_number": "901-435-8550",
"fax_number": "901-516-0933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 UNION AVE STE 965",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-435-8550",
"fax_number": "901-516-0933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMMELSTEIN",
"first_name": "STEVAN",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MS",
"license": "12664",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "20638",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "MS",
"license": "12664",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "TN",
"license": "20638",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117357001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "6092182",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00115478",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3807173",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.