Peter Stach, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP198085 Issued in OR

Practice address

4770 SW Watson Ave
Beaverton, OR 97005-0511

Phone

(503) 805-4720

Fax

(971) 223-0969

NPI assigned

Jul 18, 2017

Last updated

Jun 27, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Western Un of HLTH Sciences, Col of Podiatric Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridge City Foot and Ankle LLCGroup PAC ID 3577975762, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dr.stach@bcfaa.com

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.

• Bridge City Foot & Ankle LLC

  • Podiatrist
  • Beaverton, OR
  • NPI 1669074316
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1366965675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 SW WATSON AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050511",
            "telephone_number": "503-805-4720",
            "fax_number": "971-223-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 SW WATSON AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050511",
            "telephone_number": "503-805-4720",
            "fax_number": "971-223-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACH",
        "first_name": "PETER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-06-27",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP198085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.stach@bcfaa.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "4770 SW Watson Ave",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970050511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Podiatrist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.