Individual provider Active NPI

Todd Staub, NP-C

  • Nurse Practitioner
  • Gettysburg, PA
National Provider Identifier
1144505975
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP011654 Issued in PA
Practice address
40 V Twin Dr
Gettysburg, PA 17325-7875
Phone
(717) 339-2560
NPI assigned
Oct 12, 2011
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP011654 PA Primary

Addresses

Primary practice location

40 V Twin Dr
Gettysburg, PA 17325-7875

Mailing address

601 Memory LN
York, PA 17402-2231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000215 PA Practitioner - Nurse Practitioner 0446426795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Physician ServicesGroup PAC ID 5496728172, 102 clinicians

Practice addresses (Care Compare)

40 V Twin Dr
Gettysburg, PA 17325-7875
Phone (717) 339-2560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
94.86
Promoting interoperability
95
Improvement activities
40
Cost
79.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011654PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Physician Services CurrentSince Mar 17, 2025 Accepting new patients
Good Samaritan Physician Services CurrentSince Mar 17, 2025 Accepting new patients
Good Samaritan Physician Services Current Accepting new patients
Respiratory Specialists LTD PastSince Nov 1, 2011 Accepting new patients

Locations

40 V Twin Dr
Gettysburg, PA 17325
Phone (717) 339-2424

844 Tuck St
Lebanon, PA 17042
Phone (717) 274-8875

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: tstaub466264@wellspan.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 6

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": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1144505975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 V TWIN DR",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173257875",
            "telephone_number": "717-339-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUB",
        "first_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

Verify at the official NPI Registry.