Individual provider Active NPI

Jon G Staffel, MD

  • Specialist
  • Memphis, TN
National Provider Identifier
1437114790
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
6133 Poplar Pike
Memphis, TN 38119-4707
Phone
(901) 761-9720
Fax
(901) 683-8440
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

6133 Poplar Pike
Memphis, TN 38119-4707

Mailing address

PO Box 17987
Memphis, TN 38187-0987
Phone (901) 761-9720

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110401000819 TN Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9739363565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Texas Tech University Health Science Center School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shea ClinicGroup PAC ID 3971525635, 7 clinicians

Practice addresses (Care Compare)

6133 Poplar Pike
Memphis, TN 38119-4707
Phone (901) 761-9720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.26 of 100Reported as group
Quality
89.71
Improvement activities
40
Cost
77.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shea Clinic CurrentSince Jul 1, 1998 Accepting new patients
Shea Clinic Specialist CurrentSince Jul 1, 1998 Accepting new patients

Locations

6133 Poplar Pike
Memphis, TN 38119
Phone (901) 737-8571

Interoperability endpoints

  • Direct secure messaging: jstaffel27804@mlh.direct-ci.com

Organizations & group practices 2

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 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1437114790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17987",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381870987",
            "telephone_number": "901-761-9720",
            "fax_number": "901-683-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6133 POPLAR PIKE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194707",
            "telephone_number": "901-761-9720",
            "fax_number": "901-683-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFEL",
        "first_name": "JON",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.