Mary Jo Stastny, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

27088 Issued in WI

Practice address

10 Tri Park Way
Appleton, WI 54914-1658

Phone

(920) 831-7919

Fax

(920) 831-7939

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Milwaukee Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Appleton, WI
  • NPI 1669643912
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073533402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-7919",
            "fax_number": "920-831-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-7919",
            "fax_number": "920-831-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASTNY",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "27088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Stample, APNP
• Roger Gary Stanek, D.D.S.
• Eric Jon Stanelle, M.D.
• Ryan Stanke, PHARMD
• Star Bright Therapy LLC
• Statewide Group Homes LLC
• C Danae Steele
• Bailey Stefancic, SAC-IT
• Linda J. Steffen, PSY.D.
• Joseph Steffens

• Internal Medicine Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.