NPIMap

Individual provider Active NPI

Arunthathi Tabitha Stallwood, MD

  • Internal Medicine Physician
  • Marysville, MI
National Provider Identifier
1972899680
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301099109 Issued in MI
Practice address
1985 Gratiot Blvd
Marysville, MI 48040-2215
Phone
(810) 364-0692
Fax
(810) 364-0698
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301099109 MI Primary
Pediatrics Physician 208000000X 4301099109 MI

Addresses

Primary practice location

1985 Gratiot Blvd
Marysville, MI 48040-2215

Mailing address

PO Box 610669
Port Huron, MI 48061-0669
Phone (810) 985-1884

Other names 1

  • Arunthathi Tabitha Abraham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804004866 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3476867433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Loma Linda University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue408
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301099109MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Sep 13, 2021 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Jan 15, 2019 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Macomb Hospital Corporation Internal Medicine Current Accepting new patients
Henry Ford Macomb Hospital Corporation Internal Medicine CurrentSince Jan 15, 2019 Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Sep 13, 2021 Accepting new patients

Locations

80650 Van Dyke Rd
Bruce Twp, MI 48065
Phone (810) 798-6410

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

Interoperability endpoints

  • Direct secure messaging: astallwood562920@direct.hfhs.org

Organizations & group practices 7

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 4

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1972899680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610669",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480610669",
            "telephone_number": "810-985-1884",
            "fax_number": "810-966-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402215",
            "telephone_number": "810-364-0692",
            "fax_number": "810-364-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWOOD",
        "first_name": "ARUNTHATHI",
        "middle_name": "TABITHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301099109",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301099109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARUNTHATHI",
            "last_name": "ABRAHAM",
            "middle_name": "TABITHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marysville, MI

Sources for this page

Verify at the official NPI Registry.