Tom Stathakios, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

058286 Issued in MI

Practice address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone

(313) 436-2374

NPI assigned

Nov 17, 2006

Last updated

Mar 17, 2018By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in MI

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

Wayne State University School of Medicine, 1987

Medicare assignment

May accept Medicare assignment

Group practices

Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI

  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Anesthesiology Physician
  • Detroit, MI
  • NPI 1003989690
  NPD
• Henry Ford Health System

  • Podiatrist
  • Detroit, MI
  • NPI 1396824207
  NPD

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

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255405767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "SUTIE A327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5450 Fort St",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481834601",
            "country_code": "US",
            "telephone_number": "734-671-3666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33155 Annapolis St",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "MI",
            "postal_code": "481842405",
            "country_code": "US",
            "telephone_number": "734-467-4667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATHAKIOS",
        "first_name": "TOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "058286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104156743",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI BCBS",
            "identifier": "050H26218",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIGTBA MEDICARE REASSIGN",
            "identifier": "P52260001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Matthew P Steffes, M.D.

• Anesthesiology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• 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.