Active NPI
Jacquelenn Marie Stuhldreher, MD
- Vascular Surgery Physician
- Hampton, VA
National Provider Identifier
1952563728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 0101266205
- Practice address
- 3000 Coliseum Dr Ste 100
Hampton, VA 23666-5963 - Phone
- (757) 736-7250
- Fax
- (757) 224-2198
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 35121246 | OH | |
| Vascular Surgery Physician | 2086S0129X | 35.121246 | OH | |
| Vascular Surgery Physician | 2086S0129X | 0101266205 | VA | Primary |
Addresses
Primary practice location
3000 Coliseum Dr Ste 100
Hampton, VA 23666-5963
Mailing address
3000 Coliseum Dr Ste 100
Hampton, VA 23666-5963
Phone (757) 736-7250
Other practice location 1
500 J Clyde Morris Blvd Ste 603
Newport News, VA 23601-1929
Phone (757) 534-5340
Other practice location 2
2300 Miami Valley Dr Ste 350
Centerville, OH 45459-1294
Phone (937) 438-8640
Other practice location 3
34800 Bob Wilson Dr
Vascular Surgery
San Diego, CA 92134-1098
Phone (619) 532-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0384878 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Emory University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673
3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222
5818 Harbour View Blvd
Suffolk, VA 23435-3315
Hospital & facility affiliations
- Bon Secours Maryview Medical Center
- Bon Secours Harbour View Medical Center
- Sentara Norfolk General Hospital
- Sentara Obici Hospital
- Bon Secours Southampton Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35121246 | OH | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Physician Services, Inc. | Vascular Surgery | Current | Accepting new patients |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Current | Accepting new patients |
Locations
3000 Coliseum Dr
Ste 100
Hampton, VA 23666
Phone (757) 736-7250
856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900
500 J Clyde Morris Blvd
Ste 603
Newport News, VA 23601
Phone (757) 534-5340
858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343
150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944
8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462
1020 Bon Secours Dr
Ste 240
Suffolk, VA 23435
Phone (757) 483-8268
Interoperability endpoints
- jstuhldreher588253@direct.sentara.net
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 and National Provider Directory roles.
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- Cardiovascular Disease Physician
- Richmond, VA
- NPI 1629637475
-
- Gastroenterology Physician
- Newport News, VA
- NPI 1194929026
-
- Durable Medical Equipment & Medical Supplies
- Franklin, VA
- NPI 1205451028
-
- Gastroenterology Physician
- Williamsburg, VA
- NPI 1083867311
-
- Family Medicine Physician
- Newport News, VA
- NPI 1710020623
Vascular Surgery
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Franklin, VA
- NPI 1851936983
-
- General Acute Care Hospital
- Suffolk, VA
- NPI 1104658434
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1952563728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 COLISEUM DR STE 100",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665963",
"telephone_number": "757-736-7250",
"fax_number": "757-224-2198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 COLISEUM DR STE 100",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665963",
"telephone_number": "757-736-7250",
"fax_number": "757-224-2198"
}
],
"practiceLocations": [
{
"address_1": "500 J Clyde Morris Blvd Ste 603",
"address_purpose": "LOCATION",
"city": "Newport News",
"state": "VA",
"postal_code": "236011929",
"country_code": "US",
"telephone_number": "757-534-5340",
"fax_number": "757-594-3456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2300 Miami Valley Dr Ste 350",
"address_purpose": "LOCATION",
"city": "Centerville",
"state": "OH",
"postal_code": "454591294",
"country_code": "US",
"telephone_number": "937-438-8640",
"fax_number": "937-438-8615",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34800 Bob Wilson Dr",
"address_2": "Vascular Surgery",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "619-532-6400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STUHLDREHER",
"first_name": "JACQUELENN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OH",
"license": "35121246",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OH",
"license": "35.121246",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "VA",
"license": "0101266205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0384878",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.