Dr Stephen E Southard Jr, MD is a medicare enrolled "Internal Medicine" physician in Erie, Colorado. His current practice location is
1160 Hickory Way, Erie, Colorado. You can reach out to his office (for appointments etc.) via phone at
(617) 840-8445.
Dr Stephen E Southard Jr is licensed to practice in Colorado (license number CDRH.0061297) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1316074776.
Physician's Profile
| Full Name | Dr Stephen E Southard Jr |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 1160 Hickory Way, Erie, Colorado |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1316074776
- Provider Enumeration Date: 02/27/2007
- Last Update Date: 08/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 1355494303
- Enrollment ID: I20090808000091
Medical Identifiers
Medical identifiers for Dr Stephen E Southard Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316074776 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | L-228504 (Massachusetts) | Secondary |
| 207R00000X | Internal Medicine | 38056 (Alabama) | Secondary |
| 207R00000X | Internal Medicine | 18759 (Nevada) | Secondary |
| 207R00000X | Internal Medicine | 59425 (Tennessee) | Secondary |
| 207R00000X | Internal Medicine | 11224295-1205 (Utah) | Secondary |
| 207R00000X | Internal Medicine | C197633 (California) | Secondary |
| 207R00000X | Internal Medicine | 01094663A (Indiana) | Secondary |
| 207R00000X | Internal Medicine | 102003 (Georgia) | Secondary |
| 207R00000X | Internal Medicine | 2024036775 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 2024-02849 (North Carolina) | Secondary |
| 207R00000X | Internal Medicine | V5609 (Texas) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | 1043889967 (New York) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | 1992372403 (Connecticut) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | 1992372403 (New Jersey) | Secondary |
| 207R00000X | Internal Medicine | CDRH.0061297 (Colorado) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Stephen E Southard Jr allows following entities to bill medicare on his behalf.
| Entity Name | Wellesley Primary Care Medicine, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750502795
PECOS PAC ID: 7810092236
Enrollment ID: O20070413000215 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Stephen E Southard Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Stephen E Southard Jr, MD
1160 Hickory Way,
Erie, CO 80516-7994
Ph: (617) 840-8445 | Dr Stephen E Southard Jr, MD
1160 Hickory Way,
Erie, CO 80516-7994
Ph: (617) 840-8445 |
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