Individual provider Active NPI

Michael P Stanich, DO

  • Orthopaedic Surgery Physician
  • Youngstown, OH
National Provider Identifier
1114986015
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
34003460 Issued in OH
Practice address
7067 Tiffany Blvd
Suite 150
Youngstown, OH 44514-1981
Phone
(330) 726-9077
Fax
(330) 726-8715
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 34003460 OH Primary

Addresses

Primary practice location

7067 Tiffany Blvd
Suite 150
Youngstown, OH 44514-1981

Mailing address

7067 Tiffany Blvd
Suite 150
Youngstown, OH 44514-1981
Phone (330) 726-9077

Other identifiers 1

IdentifierTypeStateIssuer
0516098MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100407000240 OH Practitioner - Orthopedic Surgery 4385770908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Mid West Medical College, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

250 Debartolo PL
Suite 1000
Youngstown, OH 44512-6090
Phone (330) 729-8000

7629 Market St
Youngstown, OH 44512-6051

Hospital & facility affiliations

  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3460OHMDChiropractor
003460OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Orthopaedic Surgery CurrentSince Feb 1, 2020 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

250 Debartolo Pl
Ste B
Youngstown, OH 44512
Phone (234) 683-1015

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

250 Debartolo Pl
Ste C
Youngstown, OH 44512

7067 Tiffany Blvd
Ste 150
Youngstown, OH 44514
Phone (330) 726-9077

Organizations & group practices 2

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1114986015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7067 TIFFANY BLVD",
            "address_2": "SUITE 150",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445141981",
            "telephone_number": "330-726-9077",
            "fax_number": "330-726-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7067 TIFFANY BLVD",
            "address_2": "SUITE 150",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445141981",
            "telephone_number": "330-726-9077",
            "fax_number": "330-726-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANICH",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "34003460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0516098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.