Ethan Dean Stahl

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

234 E 149TH St
Bronx, NY 10451-5504

Phone

(844) 692-4692

NPI assigned

May 16, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1457098071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HENRY ST APT 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "844-692-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "ETHAN",
        "middle_name": "DEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takiyah Tanner Stafford-Robinson, M.S.ED
• Precious Stafford
• Ursula Ma Stafford
• Stahl Surgical Supply Inc
• Eric Stahl, MD
• Howard Stahl
• Jonathan Delong Staley, DDS
• Denae Stallings, LCSW
• Donnetta Stallings, LCSW
• Savino J Stallone, CHES

• Student in an Organized Health Care Education/Training Program in Bronx, NY
• Providers in Bronx, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.