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THEODORE B STEM JR. M.D.
NPI 1538160049
Internal Medicine - Nephrology in Greensburg, PA

Active since August 09, 2005PECOS EnrolledAccepts Medicare Assignment
562 SHEARER ST, GREENSBURG, PA 15601(724) 836-8303(724) 836-8311 Get Directions Write a Review

NPPES record last updated: September 8, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Theodore B Stem Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE B STEM JR. M.D. (NPI 1538160049) is an individual nephrology provider in Greensburg, Pennsylvania, licensed in North Carolina (2016-01133) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with North Carolina Baptist Hospital, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1538160049
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameTHEODORE B STEM JR.Credential: M.D.
Location Address562 SHEARER STGreensburg, PA 15601-2746
Mailing AddressMedical Center BlvdWinston Salem, NC 27157-0001 · (336) 716-2255 · Fax (336) 716-3202
Phone(724) 836-8303
Fax(724) 836-8311
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateAugust 9, 2005
Last NPPES UpdateSeptember 8, 2016
✔ NPI 1538160049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in NC · 2016-01133
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
562 SHEARER ST, Greensburg, PA 15601
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Other Identifiers 3

Medicare UPINC34499PA
Medicaid0010404120001PA
Medicare PIN472416HXCPA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theodore B Stem Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507950805
PECOS Enrollment IDI20161013000616
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
401 services197 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
20 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340047
LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County
Emergency services Birthing friendly

Wilkes Regional Medical Center

Acute Care Hospitals · North Wilkesboro, NC
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340064
Location1370 West D StNorth Wilkesboro, NC 28659 · Wilkes County
Emergency services Birthing friendly

Lexington Memorial Hospital Inc

Acute Care Hospitals · Lexington, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340096
Location250 Hospital Drive PO Box 1817Lexington, NC 27293 · Davidson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Azathioprine, oral, 50 mg J7500
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers12 claims270 services$2.44 avg. paid by Medicare
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
1 supplier37 claims20,080 services$1.21 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers86 claims10,695 services$0.30 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers98 claims15,150 services$0.01 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers29 claims3,960 services$0.19 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers82 claims14,940 services$0.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTIN A. MURCEK, M.D., LTD.
Allergy & Immunology
562 SHEARER ST, SUITE 101-2
GREENSBURG, PA 15601
Westmoreland County (724) 837-4070
DONNA M SCARLETT RD, LDN
Dietitian, Registered (Nutrition, Renal)
562 SHEARER ST, CKD SERVICES OF GREENSBURG
GREENSBURG, PA 15601
Westmoreland County (724) 832-8061
DR. NAGARAJAN RAMAKRISHNAN MD
Internal Medicine (Critical Care Medicine)
562 SHEARER ST, MEDICAL ARTS BLDG SUITE # 203
GREENSBURG, PA 15601
Westmoreland County (724) 837-1894
DR. RALPH EDWARD RITENOUR JR. D.M.D.
Dentist (General Practice)
562 SHEARER ST, SUITE 304
GREENSBURG, PA 15601
Westmoreland County (724) 832-4888
SARAH KELLEY D.O.
Obstetrics & Gynecology
562 SHEARER ST, SUITE 103
GREENSBURG, PA 15601
Westmoreland County (724) 850-3150
DR. THOMAS J MARTIN MD
Internal Medicine (Pulmonary Disease)
562 SHEARER ST, SUITE 203
GREENSBURG, PA 15601
Westmoreland County (724) 837-1894
MRS. DEBORA ERB HOLETS-ROSSI RN, CRNP
Nurse Practitioner (Acute Care)
562 SHEARER ST
GREENSBURG, PA 15601
Westmoreland County (724) 832-8061
ROBERT H FERGUSON M.D.
Internal Medicine (Nephrology)
562 SHEARER ST
GREENSBURG, PA 15601
Westmoreland County (724) 836-8303

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Stem's NPI number?

The NPI number for Theodore Stem is 1538160049. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Where is Theodore Stem located?

Theodore Stem practices at 562 Shearer St, Greensburg, PA 15601. The listed phone number is (724) 836-8303.

What is Theodore Stem's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Theodore Stem enrolled in Medicare?

Yes. Theodore Stem is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Stem accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 1 other insurer list Theodore Stem as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Stem affiliated with any hospitals?

According to CMS data, Theodore Stem is affiliated with North Carolina Baptist Hospital, Wilkes Regional Medical Center and Lexington Memorial Hospital Inc.

When was this NPI record last updated?

The NPPES record for Theodore Stem was last updated on September 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.