STEPHAN J VIVIAN (MD) – Clinical Cardiac Electrophysiology Physician, NPI 1619975877
Clinical Cardiac Electrophysiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for STEPHAN J VIVIAN (MD)
1802, Braeburn Drive, Braeburn, Salem, Salem (city), Virginia, 24153, United States
SALEM, VA 241537357
Phone: (540) 772-3819
Type: Location
7916 W JEFFERSON BLVD
FORT WAYNE, IN 468044140
Phone: (260) 434-2297
Fax: (260) 434-6116
Type: Mailing
7916 W Jefferson Blvd
Fort Wayne, IN 468044140
Phone: (540) 772-3819
Type: Location
500 J CLYDE MORRIS BLVD FL ANNEX1
NEWPORT NEWS, VA 236011929
Phone: (757) 594-2074
Fax: (757) 594-3369
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: 2008-01-08
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 |
|---|---|---|---|---|
| I20080108000739 | I | Cardiac Electrophysiology | VA | 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 24153)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | VA | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Infectious Disease | IN | |
| - | IN | |
| Family Practice | IN | |
| Nurse Practitioner | IN | |
| U R O L O G Y | MI | |
| Internal Medicine | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Cardiovascular Disease (Cardiology) | IN | |
| Family Practice | IN |
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