Michael Todd Stafford, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

F7193 Issued in TX

Practice address

3560 Delaware St
Suite 601-a
Beaumont, TX 77706-3067

Phone

(800) 258-2016

Fax

(409) 924-9696

NPI assigned

Jan 11, 2007

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 4

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Locations

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.

• Jackson County Hospital District

  • Emergency Medicine Physician
  • Edna, TX
  • NPI 1215971478
  Medicare reassignment NPD
• Port Arthur Emergency Physicians

  • Emergency Medicine Physician
  • Port Arthur, TX
  • NPI 1255491627
  Medicare reassignment NPD
• Jackson County Hospital District

  • Rural Health Clinic/Center
  • Ganado, TX
  • NPI 1679445654
  NPD
• Refugio County Memorial Hospital District

  • Critical Access Hospital
  • Refugio, TX
  • NPI 1942240189
  NPD (past)
• Southeast Emergency Physician Associates, P.a.

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1235155102
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1285784298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 COUNTRY SQUIRE DRIVE",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774066642",
            "telephone_number": "281-341-7676",
            "fax_number": "409-924-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "SUITE 601-A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063067",
            "telephone_number": "800-258-2016",
            "fax_number": "409-924-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "F7193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0815925",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1380487-06",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81680B",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5994380",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SS Powers Dental, P.a.
• SSC Beaumont Green Acres Operating Company LLC
• Pamela Ann St Amand, MD
• St Elizabeth Rehab Partners, LLP
• Rayann St. Peter, LPC
• Tamara Stafford, LVN
• Kevin R Stahl, DO
• Brian Edward Stampley, LPC
• Bonni Blue Stancoven, CRNA
• Wendi Stanley, MSN, APN, NNP-BC

• Emergency Medicine Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.