Healthcare Provider Details

I. General information

NPI: 1700851862
Provider Name (Legal Business Name): STEPHEN W TIFFT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PETERS ROAD SUITE 202
LITITZ PA
17543-7685
US

IV. Provider business mailing address

1570 FRUITVILLE PIKE
LANCASTER PA
17601-4056
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-6481
  • Fax: 717-569-5213
Mailing address:
  • Phone: 717-569-6481
  • Fax: 717-569-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD019948E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0006619300003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier01653801
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE CROSS
# 3
Identifier153461
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD
# 4
IdentifierB40046
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH ASSURANCE
# 5
Identifier0006619300001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 6
Identifier1142862
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAMERIHEALTH MERCY HEALTH
# 7
Identifier4471404
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA NON-HMO
# 8
Identifier43413 S1BX
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER HEALTH PLAN
# 9
Identifier539900
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA NON-HMO
# 10
IdentifierP002656
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGATEWAY HEALTH PLAN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: