Individual provider Active NPI

Jacob M Stanfield, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Richland, WA
National Provider Identifier
1164740403
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
MD60630896 Issued in WA
Practice address
875 Swift Blvd
Richland, WA 99352-3592
Phone
(509) 946-1654
Fax
(509) 943-5652
NPI assigned
May 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD60630896 WA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD60630896 WA Primary

Addresses

Primary practice location

875 Swift Blvd
Richland, WA 99352-3592

Mailing address

560 Gage Blvd
Suite 203
Richland, WA 99352
Phone (509) 942-3627

Other identifiers 2

IdentifierTypeStateIssuer
1164740403MedicaidKY
1164740403MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstanfield1108975@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160921000987 WA Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 2769700798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

1351 Fowler St
Richland, WA 99352-4714
Phone (509) 946-1654

875 Swift Blvd
Suite a
Richland, WA 99352-3592
Phone (509) 946-1654

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement82
Knee replacement143
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Apr 1, 2017 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Apr 1, 2017 Accepting new patients

Locations

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

560 Gage Blvd
Ste 203
Richland, WA 99352
Phone (509) 942-3135

875 Swift Blvd
Ste A
Richland, WA 99352
Phone (509) 942-2573

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

875 Swift Blvd
Richland, WA 99352
Phone (509) 943-8977

Interoperability endpoints

  • Direct secure messaging: jstanfield1108975@wm.providencedirect.org

Organizations & group practices 3

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1164740403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523592",
            "telephone_number": "509-946-1654",
            "fax_number": "509-943-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFIELD",
        "first_name": "JACOB",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60630896",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60630896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164740403",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164740403",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstanfield1108975@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "875 Swift Blvd",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.