SAMUEL STAHLY – Dermatology Physician, NPI 1922685494
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
207 DERMATOLOGY in AL
Provider Addresses for SAMUEL STAHLY
7300 Halcyon Summit Dr
Montgomery, AL 361173699
Phone: (205) 977-9876
Fax: (256) 351-1876
Type: Location
802 BANK ST NE
DECATUR, AL 356011612
Phone: (205) 977-9876
Fax: (256) 351-1876
Type: Mailing
610 HIGHLAND DR
CAPE GIRARDEAU, MO 637014727
Phone:
Type: Mailing
151 SOUTHHALL LN STE 300
MAITLAND, FL 327517172
Phone: (407) 674-0886
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 80 Open Payments records for all available years, with a total value of $5,224.
Total Amount is formed as General ($5,224) + Research ($0) + Ownership ($0) = $5,224.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Janssen Scientific Affairs, LLC ($1,349).
Total Amount
$5,224
General + Research + Ownership
Payments
80
Total payment records
General Amount
$5,224
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Scientific Affairs, LLC | $1,349 |
| ABBVIE INC. | $482 |
| Amgen Inc. | $450 |
| Dermavant Sciences, Inc. | $440 |
| E.R. Squibb & Sons, L.L.C. | $313 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250718003864 | I | Dermatology | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Physician Assistant | GA | |
| Nurse Practitioner | AL | |
| - | AL | |
| Physician Assistant | AL | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | AL | |
| Emergency Medicine | AL | |
| Physician Assistant | AL |
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