NPIMap

Individual provider Active NPI

Joni Marie Stasiak, M.D.

  • Family Medicine Physician
  • Malvern, OH
National Provider Identifier
1245219187
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35067081 Issued in OH
Practice address
635 Locust Street
Malvern, OH 44644
Phone
(330) 863-9061
Fax
(330) 863-6492
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35067081 OH Primary

Addresses

Primary practice location

635 Locust Street
Malvern, OH 44644

Mailing address

635 Locust St
Malvern, OH 44644-9210
Phone (330) 863-9061

Other identifiers 4

IdentifierTypeStateIssuer
P00148632OtherOHRAILROAD MEDICARE
1389825OtherOHUNITED HEALTHCARE
000000210940OtherOHANTHEM BC BS
0187837MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110405000182 OH Practitioner - Family Practice 9335323054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll Family HealthcareGroup PAC ID 0345267431, 2 clinicians

Practice addresses (Care Compare)

635 Locust St NW
Malvern, OH 44644-9210
Phone (330) 863-9061

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067081OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Family Healthcare CurrentSince Jul 1, 2001 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: jonistasiak@cfh-oh.direct.office.nextgen.com

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 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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1245219187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 LOCUST ST",
            "city": "MALVERN",
            "state": "OH",
            "postal_code": "446449210",
            "telephone_number": "330-863-9061",
            "fax_number": "330-863-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 LOCUST STREET",
            "city": "MALVERN",
            "state": "OH",
            "postal_code": "44644",
            "telephone_number": "330-863-9061",
            "fax_number": "330-863-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASIAK",
        "first_name": "JONI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35067081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00148632",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1389825",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000210940",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187837",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, OH

Sources for this page

Verify at the official NPI Registry.