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BRIAN STONE D.O.
NPI 1972913556
Family Medicine - Sports Medicine in Indiana, PA

Active since May 05, 2014PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
120 IRMC DR STE 100, INDIANA, PA 15701(724) 427-2260 Get Directions Write a Review

NPPES record last updated: May 5, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 5, 2021, Jul 17, 2018 (2 updates tracked since 2018).

About Brian Stone D.o. NPPES

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

BRIAN STONE D.O. (NPI 1972913556) is an individual sports medicine provider in Indiana, Pennsylvania, licensed in Pennsylvania (OS019221) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Indiana Regional Medical Center, and maintains a secondary practice location in Pittsburgh.

NPPES Registry Identity

NPI1972913556
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameBRIAN STONECredential: D.O.
Location Address120 IRMC DR STE 100Indiana, PA 15701
Mailing Address640 Kolter DrIndiana, PA 15701-3570 · (724) 357-7196 · Fax (724) 357-7279
Phone(724) 427-2260
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2014
Enumeration DateMay 5, 2014
Last NPPES UpdateMay 5, 20212 updates tracked since enumeration
NPPES CertifiedMay 5, 2021
✔ NPI 1972913556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in PA · OS019221
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
120 IRMC DR STE 100, Indiana, PA 15701
Open in Google Maps ↗

Secondary Practice Location 1

Location 1302 E. North Avenue, AGH GME office, Room 185Pittsburgh, PA 15212 · Phone (724) 759-4342

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brian Stone D.o. 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 ID7315235793
PECOS Enrollment IDI20180924000627
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.

Medicare Billing Reassignment

Medicare enrollment records show Brian Stone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Indiana Healthcare Physician Services, Inc
4.9 mi
Radiation Oncology
640 KOLTER DR
Indiana, PA 15701
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 187 clinicians in this Medicare group
NPI 1417409186 (724) 357-7196

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.
56 services34 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
46 services34 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
25 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Indiana Regional Medical Center

Acute Care Hospitals · Indiana, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390173
Location835 Hospital RoadIndiana, PA 15701 · Indiana County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15701 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

DR. MICHAEL VINCENT SUFFREDINI DO
Family Medicine (Sports Medicine)
120 IRMC DR STE 100
INDIANA, PA 15701
Indiana County (727) 357-8367
GRANT INGALLS MPAS
Physician Assistant
120 IRMC DR STE 100
INDIANA, PA 15701
Indiana County (724) 427-2707
DR. ZEFR WEI-TIAN CHAO MD
Internal Medicine (Rheumatology)
120 IRMC DR STE 100
INDIANA, PA 15701
Indiana County (724) 427-2260
DR. SATHISH PRABU SATHYAMANGALAM SAMIAPPAN MD
Neurological Surgery
120 IRMC DR STE 100
INDIANA, PA 15701
Indiana County (724) 427-2260

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 Brian Stone's NPI number?

The NPI number for Brian Stone is 1972913556. It was assigned to this individual provider in the NPPES registry on May 5, 2014.

Where is Brian Stone located?

Brian Stone practices at 120 Irmc Dr Ste 100, Indiana, PA 15701. The listed phone number is (724) 427-2260.

What is Brian Stone's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Brian Stone enrolled in Medicare?

Yes. Brian Stone 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.

Which organization bills Medicare for Brian Stone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Stone reassigns Medicare benefits to Indiana Healthcare Physician Services, Inc (Indiana, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brian Stone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brian Stone accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Brian Stone 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 Brian Stone affiliated with any hospitals?

According to CMS data, Brian Stone is affiliated with Indiana Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Brian Stone was last updated on May 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.