NPIMap

Individual provider Active NPI

Jessica L Stachyra, DO

  • Neurology Physician
  • Springfield, OR
National Provider Identifier
1265875082
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DO183523 Issued in OR
Practice address
1 Hayden Bridge Way
Springfield, OR 97477-1347
Phone
(541) 868-9430
Fax
(541) 868-9450
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DO183523 OR Primary

Addresses

Primary practice location

1 Hayden Bridge Way
Springfield, OR 97477-1347

Mailing address

1 Hayden Bridge Way
Springfield, OR 97477-1347
Phone (415) 868-9430

Other identifiers 1

IdentifierTypeStateIssuer
DO183523OtherORMEDICAL LICENSE

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
I20180601000898 OR Practitioner - Neurology 5395019566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of North Texas HSC, College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Associates Eugene-Springfield PCGroup PAC ID 0446246888, 9 clinicians

Practice addresses (Care Compare)

1 Hayden Bridge Way
Springfield, OR 97477-1347
Phone (541) 868-9430

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
Neurology Associates Eugene-Springfield PC Neurology CurrentSince Aug 1, 2019 Accepting new patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
University Professional Services Current Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Ste 8
Portland, OR 97239
Phone (503) 494-7772

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

1 Hayden Bridge Way
Springfield, OR 97477
Phone (541) 686-2837

Interoperability endpoints

  • Direct secure messaging: jstachyr@yourcarecommunity.org

Organizations & group practices 4

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1265875082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771347",
            "telephone_number": "415-868-9430",
            "fax_number": "541-868-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771347",
            "telephone_number": "541-868-9430",
            "fax_number": "541-868-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHYRA",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "DO183523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "DO183523",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.