Individual provider Active NPI

Jon Turner Stauffer, M.D.

  • Gastroenterology Physician
  • Rockport, ME
National Provider Identifier
1194720177
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DR.0028979 Issued in CO
Practice address
4 Glen Cove Dr Ste 10
Rockport, ME 04856-4235
Phone
(207) 301-5970
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD27231 ME
Gastroenterology Physician 207RG0100X DR.0028979 CO Primary

Addresses

Primary practice location

4 Glen Cove Dr Ste 10
Rockport, ME 04856-4235

Mailing address

104 Walnut St
Rockport, IN 47635-1356
Phone (229) 221-8057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20231024001246 ME Practitioner - GastroenterologyPractitioner - Internal Medicine 5991841769
I20231117002294 IN Practitioner - Gastroenterology 5991841769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Columbia University College of Physicians and Surgeons, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Care of Evansville PCGroup PAC ID 8022119858, 27 clinicians

Practice addresses (Care Compare)

3800 Venetian Way
Newburgh, IN 47630-8257
Phone (812) 477-6103

Hospital & facility affiliations

  • Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115
  • Daviess Community Hospital Hospital, Washington, IN, CCN 150061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy89
Upper gastrointestinal (GI) endoscopy for acid reflux146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0028979COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Care of Evansville PC Gastroenterology CurrentSince Dec 1, 2023 Accepting new patients
Digestive Care of Evansville, PC CurrentSince Dec 1, 2023 Accepting new patients
Dalton Cardiology, P.C. Past Accepting new patients

Locations

647 2nd St
Ste A
Jasper, IN 47546
Phone (812) 477-6103

647 2nd St
Ste B
Jasper, IN 47546
Phone (812) 477-6103

3800 Venetian Way
Newburgh, IN 47630
Phone (812) 477-6103

Interoperability endpoints

  • Direct secure messaging: jstauffer84319@direct.owensborohealth.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 5

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1194720177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WALNUT ST",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476351356",
            "telephone_number": "229-221-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GLEN COVE DR STE 10",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564235",
            "telephone_number": "207-301-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "JON",
        "middle_name": "TURNER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD27231",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0028979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.