Nick Stavridis, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

3565 Issued in AZ

Practice address

6644 E Baywood Ave
Mesa, AZ 85206

Phone

(480) 981-4200

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 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 2

Specialty

Emergency Medicine

Education

Ohio University, College of Osteopathic Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FHMC ClinicGroup PAC ID 8729497706, 19 clinicians

FHMC Operating PCGroup PAC ID 2961818976, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• FHMC Clinic

  • Emergency Medicine Physician
  • Fountain Hills, AZ
  • NPI 1043830623
  Medicare reassignment Care Compare group NPD
• FHMC Operating PC

  • Adult Medicine Physician
  • Fountain HLS, AZ
  • NPI 1295355881

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment NPD
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Mountain Vista Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1164642963
  Medicare reassignment NPD
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment NPD
• Quantum Healthcare Medical Associates of Arizona, PC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1821391269

  AZ

  Medicare reassignment NPD
• Solano Gateway Medical Group Inc

  • Emergency Medicine Physician
  • Fairfield, CA
  • NPI 1952344293
  Medicare reassignment NPD
• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment
• Fountain Hills Medical Center LLC

  • Emergency Care Clinic/Center
  • Fountain Hills, AZ
  • NPI 1609496397
  NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1114908696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HOPYARD RD",
            "address_2": "SUITE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883348",
            "telephone_number": "800-617-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-981-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 N Saguaro Blvd",
            "address_purpose": "LOCATION",
            "city": "Fountain Hills",
            "state": "AZ",
            "postal_code": "852686241",
            "country_code": "US",
            "telephone_number": "602-671-7990",
            "fax_number": "602-755-0457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVRIDIS",
        "first_name": "NICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH GRP",
            "identifier": "453051001",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "548646",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GRP",
            "identifier": "3981220",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GRP",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GROUP",
            "identifier": "860373636",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Statclinix PLC
• State 48 Counseling
• Stateserv Homecare LLC
• Laura Ellen Staubitz, RN
• Charles Bennett Stauffer, M.D.
• Steadfast Health LLC
• Steadfast Love Hospice, LLC
• Amanda Stearman, PTA
• Emily Stebbins
• Margaret Elizabeth Steele, N.D.

• Emergency Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.