Individual provider Active NPI

Michael Douglas Staniec, M.D.

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1497771471
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10600 Issued in AZ
Practice address
5601 W Eugie Ave
Suite 203
Glendale, AZ 85304-1255
Phone
(602) 548-1600
Fax
(602) 548-2470
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10600 AZ Primary

Addresses

Primary practice location

5601 W Eugie Ave
Suite 203
Glendale, AZ 85304-1255

Mailing address

42429 N Cross Timbers CT
Anthem, AZ 85086-1098
Phone (623) 551-1097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497771471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42429 N CROSS TIMBERS CT",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850861098",
            "telephone_number": "623-551-1097",
            "fax_number": "602-548-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W EUGIE AVE",
            "address_2": "SUITE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041255",
            "telephone_number": "602-548-1600",
            "fax_number": "602-548-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANIEC",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "10600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.