NPIMap

Individual provider Active NPI

Jesse W Staggs, PA-C

  • Physician Assistant
  • Corvallis, OR
National Provider Identifier
1235324708
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01277 Issued in OR
Practice address
3615 NW Samaritan Dr Ste 210
Corvallis, OR 97330-3771
Phone
(541) 768-4501
NPI assigned
Sep 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X LL17393 OR
Physician Assistant 363A00000X 0004251 CO
Physician Assistant 363A00000X PA01277 OR Primary

Addresses

Primary practice location

3615 NW Samaritan Dr Ste 210
Corvallis, OR 97330-3771

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstaggs7042@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070918000662 OR Practitioner - Physician Assistant 5597859744 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians
The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314
  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
84.81
Promoting interoperability
100
Improvement activities
40
Cost
75.71

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
LL17393ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Jan 15, 2015 Accepting new patients
Albany General Hospital CurrentSince Jan 15, 2015 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 1, 2012 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 1, 2012 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Physician Assistant PastSince Sep 1, 2004 Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

3615 NW Samaritan Dr
Ste 210
Corvallis, OR 97330
Phone (541) 768-4501

Interoperability endpoints

  • Direct secure messaging: jstaggs7042@samhealth.direct-ci.com

Organizations & group practices 9

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 74

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

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1235324708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NW SAMARITAN DR STE 210",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303771",
            "telephone_number": "541-768-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGS",
        "first_name": "JESSE",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-07",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "LL17393",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0004251",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstaggs7042@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3615 NW Samaritan Dr Ste 210",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.