RICHARD A STOLDT (M.D.) – Family Medicine Physician, NPI 1104863679

RICHARD A STOLDT (M.D.) is a healthcare provider. based in South bend, Indiana. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 01037182 (IN). The NPI Number for RICHARD A STOLDT (M.D.) is 1104863679

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD A STOLDT (M.D.)
NPI
1104863679
Phone
(574) 335-8700
Address
707 E CEDAR ST
Enumeration Date
1 June 2006
Last Update Date
14 September 2016

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Secondary Phone
5743358500
Graduation Year
1987 (39 years ago)
PAC ID
4284767849
Group Practice PAC ID
8325950843
Professional Enrollment ID
I20100803000355
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for RICHARD A STOLDT (M.D.)

  • Cedar Street, South Bend, Saint Joseph County, Indiana, 46617, United States

    STE 200

    SOUTH BEND, IN 466172057

    Phone: (574) 335-8700

    Fax: (574) 335-0760

    Type: Mailing

  • Cleveland Road, South Bend, Saint Joseph County, Indiana, 46628, United States

    SOUTH BEND, IN 466286090

    Phone: (574) 520-2707

    Fax: (574) 520-2700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-08-03

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
I20100803000355IFamily PracticeINTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46617)

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Provider's Procedures

RICHARD A STOLDT (M.D.) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEIN83036Hemoglobin A1C level4335

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: 8325950843View full group profile
NameSpecialtyState
Family PracticeIN
Nurse PractitionerIN
Internal Medicine, Family Practice, Emergency MedicineIN
-IN
-IN
N E U R O L O G YIL
-IN
U R O L O G YFL
Physician AssistantMN
Nurse PractitionerIN

Reviews

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Frequently asked questions

What unique ID ties claims to RICHARD A STOLDT (M.D.)?
NPI 1104863679 is assigned to RICHARD A STOLDT (M.D.) under the national enumeration system.
Is RICHARD A STOLDT (M.D.) active in the national directory?
RICHARD A STOLDT (M.D.)'s public NPI profile is in an active state.
What field does RICHARD A STOLDT (M.D.) work in?
You can think of RICHARD A STOLDT (M.D.) as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for RICHARD A STOLDT (M.D.)?
We surface South Bend, Indiana for RICHARD A STOLDT (M.D.) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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