Mark Carless Stachel, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35060372 Issued in OH

Practice address

170 W Mohawk Dr
Malvern, OH 44644-9564

Phone

(330) 489-1477

Fax

(330) 430-6925

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608336000000",
    "number": "1215930946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W MOHAWK DR",
            "city": "MALVERN",
            "state": "OH",
            "postal_code": "446449564",
            "telephone_number": "330-489-1477",
            "fax_number": "330-430-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W MOHAWK DR",
            "city": "MALVERN",
            "state": "OH",
            "postal_code": "446449564",
            "telephone_number": "330-489-1477",
            "fax_number": "330-430-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHEL",
        "first_name": "MARK",
        "middle_name": "CARLESS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-12-19",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35060372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMA CARE",
            "identifier": "1001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "341684794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000136651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110050485",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0839874",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "34168479400",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Ann Lemasters
• Alexis Renee McCartney-Green
• Rachel D Scott
• Sara Renee Sherrard
• Tracy Sphon, LPN
• Joni Marie Stasiak, M.D.
• Steven Richard Stasiak, M.D.
• Tara N Timms
• Adam Wackerly
• Victor F. Wallace, D.D.S.

• Internal Medicine Physician in Malvern, OH
• Providers in Malvern, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.