Individual provider Active NPI

Jenna Staikoff, AA

  • Anesthesiologist Assistant
  • Canton, OH
National Provider Identifier
1386267573
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000373 Issued in OH
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2641
Phone
(330) 489-1000
NPI assigned
May 21, 2020
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000373 OH Primary

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2641

Mailing address

5409 Oakes Rd
Brecksville, OH 44141-2624
Phone (440) 465-1726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200601002970 OH Practitioner - Anesthesiology Assistant 9234550120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Aug 28, 2024 Accepting new patients
Ohio Anesthesia Group, Inc CurrentSince May 29, 2020 Accepting new patients
The Metrohealth System CurrentSince Aug 28, 2024 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

4665 Douglas Cir NW
Ste 100
Canton, OH 44718
Phone (330) 499-5700

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

7000 Whipple Ave NW
North Canton, OH 44720
Phone (330) 498-9898

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1386267573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 OAKES RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412624",
            "telephone_number": "440-465-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082641",
            "telephone_number": "330-489-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAIKOFF",
        "first_name": "JENNA",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.