CHARLES EMMET JR. STOUT (MD, PHD) – Vascular & Interventional Radiology Physician, NPI 1679770994

CHARLES EMMET JR. STOUT (MD, PHD) is a healthcare provider. based in Riverside, California. specializing in DIAGNOSTIC RADIOLOGY, INTERVENTIONAL RADIOLOGY. They hold the professional credentials MD, PHD. They hold a License No. A100577 (CA). The NPI Number for CHARLES EMMET JR. STOUT (MD, PHD) is 1679770994

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES EMMET JR. STOUT (MD, PHD)
NPI
1679770994
Phone
(951) 338-4910
Address
4445 MAGNOLIA AVE
Enumeration Date
29 June 2007
Last Update Date
30 October 2023

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9513384910
Graduation Year
2002 (24 years ago)
PAC ID
6002094216
Group Practice PAC ID
2668717125
Professional Enrollment ID
I20110616000605
Address ID
CA925014135RI4445XAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

4,800 DIAGNOSTIC RADIOLOGY in CA

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Provider Addresses for CHARLES EMMET JR. STOUT (MD, PHD)

  • Riverside Community Hospital, 4445, Magnolia Avenue, Riverside, Riverside County, California, 92501, United States

    RIVERSIDE, CA 925014135

    Phone: (951) 338-4910

    Fax: (833) 996-0004

    Type: Location

  • 714, East Redlands Boulevard, Redlands, San Bernardino County, California, 92373, United States

    REDLANDS, CA 923736109

    Phone: (951) 338-4910

    Fax: (833) 996-0004

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 73 Open Payments records for all available years, with a total value of $2,808.

Total Amount is formed as General ($2,808) + Research ($0) + Ownership ($0) = $2,808.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($800).

Total Amount

$2,808

General + Research + Ownership

Payments

73

Total payment records

General Amount

$2,808

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2011-06-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110616000605IDiagnostic RadiologyCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99291Critical care, first 30-74 minutes271148$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes8049$0
75898Imaging of blood vessel4321$0
36224Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist3229$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes3231$0
View full utilization report →

Insurance plans in this area (ZIP 92501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668717125View full group profile
NameSpecialtyState
-CA
Nurse PractitionerCA
Nurse PractitionerCA
N E U R O L O G YCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Neurology, Sleep MedicineCA
Diagnostic RadiologyCA

Reviews

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Frequently asked questions

What number should I use to identify CHARLES EMMET JR. STOUT (MD, PHD) for billing?
Administrative and clinical systems typically use NPI 1679770994 for CHARLES EMMET JR. STOUT (MD, PHD).
Does the public listing show CHARLES EMMET JR. STOUT (MD, PHD) as active?
CHARLES EMMET JR. STOUT (MD, PHD)'s NPI record reflects an active status in NPPES.
How should patients interpret CHARLES EMMET JR. STOUT (MD, PHD)'s specialty?
The extract shows Vascular & Interventional Radiology Physician for CHARLES EMMET JR. STOUT (MD, PHD). Clinical services aligned with this taxonomy classification.
Is CHARLES EMMET JR. STOUT (MD, PHD) tied to Riverside, California?
If you are local to Riverside, California, CHARLES EMMET JR. STOUT (MD, PHD) may be relevant to your search.
Why is information missing for CHARLES EMMET JR. STOUT (MD, PHD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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