Jordan W Stuckey, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

35094500 Issued in OH

Practice address

1200 Ralston Ave
Department of Surgery
Defiance, OH 43512-1396

Phone

(419) 783-6944

Fax

(419) 783-4416

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Anesthesiology

Education

Georgetown University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328
• Mercy Health - Defiance Hospital Hospital, Defiance, OH, CCN 360270

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Defiance Hospital Inc

  dba Defiance Regional Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Defiance, OH
  • NPI 1881092443

  Corporate Director

  CMS ownership
• Defiance Hospital Inc.

  dba Defiance Regional Medical Center

  • Psychiatric Hospital Unit
  • Defiance, OH
  • NPI 1598765000

  Corporate Director

  CMS ownership
• Defiance Hospital Inc.

  dba Defiance Regional Medical Center

  • Critical Access Hospital
  • Defiance, OH
  • NPI 1699775726

  Corporate Director

  CMS ownership

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Defiance Hospital Inc.

  dba Defiance Regional Medical Center

  • Critical Access Hospital
  • Defiance, OH
  • NPI 1699775726
  Care Compare affiliation
• Mercy Health - Defiance Hospital LLC

  dba Mercy Health - Defiance Hospital

  • General Acute Care Hospital
  • Defiance, OH
  • NPI 1629011234
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1205983012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RALSTON AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435121396",
            "telephone_number": "419-783-6944",
            "fax_number": "419-783-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RALSTON AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435121396",
            "telephone_number": "419-783-6944",
            "fax_number": "419-783-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "JORDAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35094500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "97054449",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00812723",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000637364",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2994014",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstuckey16398@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jon Bradford Stokey, CRNA
• Gretchen Stoller
• Alyssa N Stoy
• William H. Strawter, M.D.
• Cassandra Stuber, CNP
• Kortney Morgan Subasic, PHARMD
• Christi Subic
• Robert Rowan Summers, D.O.
• Annita Swick
• Alesha Ann Switzer, CNP

• Anesthesiology Physician in Defiance, OH
• Providers in Defiance, OH by specialty
• Anesthesiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.