Active NPI
Brian S Staiger, RPH
- Pharmacist
- Ithaca, NY
National Provider Identifier
1184938870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 054715
- Practice address
- 500 S Meadow St
Ithaca, NY 14850-5317 - Phone
- (607) 277-1772
- Fax
- (607) 277-5890
- NPI assigned
- Aug 5, 2010
- Last updated
- Aug 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 054715 | NY | Primary |
Addresses
Primary practice location
500 S Meadow St
Ithaca, NY 14850-5317
Mailing address
500 S Meadow St
Ithaca, NY 14850-5317
Phone (607) 277-1772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054715 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wegmans Food Markets, Inc. | Past | Accepting new patients | |
| Wegmans Food Markets, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1184938870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S MEADOW ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505317",
"telephone_number": "607-277-1772",
"fax_number": "607-277-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MEADOW ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505317",
"telephone_number": "607-277-1772",
"fax_number": "607-277-5890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAIGER",
"first_name": "BRIAN",
"middle_name": "S",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-05",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "054715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.