Individual provider Active NPI

Jessica Kathryn Staszak, MD

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1114360690
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2020022350 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Div Surg Accs
Saint Louis, MO 63110-1003
Phone
(314) 362-5298
Fax
(888) 824-2176
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 74536 TN
Surgery Physician 208600000X 2020022350 MO Primary
Surgical Critical Care Physician 2086S0102X 2020022350 MO

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Div Surg Accs
Saint Louis, MO 63110-1003

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-5298

Other practice location 1

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

Other practice location 2

1301 Medical Center Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

Other identifiers 1

IdentifierTypeStateIssuer
200088459MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210715004143 MO Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 9638316201 Reassigns benefits to 2 organizations
I20220812002085 IL Practitioner - General Surgery 9638316201 Reassigns benefits to 1 organization
I20250626001379 TN Practitioner - General Surgery 9638316201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-8336

Hospital & facility affiliations

  • Regional One Health Hospital, Memphis, TN, CCN 440152

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Sep 1, 2021 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Jun 1, 2025 Accepting new patients
Washington University CurrentSince Sep 10, 2021 Accepting new patients
Washington University CurrentSince Sep 1, 2021 Accepting new patients
Ut Regional One Physicians Inc Surgery CurrentSince Jun 1, 2025 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Aug 19, 2022 Accepting new patients
Barnes Jewish Hospital Past Accepting new patients

Locations

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

660 S Euclid Ave
Saint Louis, MO 63110

4921 Parkview Pl
Saint Louis, MO 63110
Phone (314) 747-4850

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

Interoperability endpoints

  • Direct secure messaging: jstaszak61649@sih.direct-ci.com
  • Direct secure messaging: jstaszak408086@direct.saint-lukes.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1114360690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-5298",
            "fax_number": "888-824-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DIV SURG ACCS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-5298",
            "fax_number": "888-824-2176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032807",
            "country_code": "US",
            "telephone_number": "901-545-7100",
            "fax_number": "901-448-8472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320028",
            "country_code": "US",
            "telephone_number": "615-322-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STASZAK",
        "first_name": "JESSICA",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TN",
            "license": "74536",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2020022350",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2020022350",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200088459",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Div Surg ACCS",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.