Michael E Stanik, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

25078 Issued in AZ

Practice address

811 Ainsworth Dr
Suite 101
Prescott, AZ 86301-1687

Phone

(928) 771-5282

Fax

(928) 771-5283

NPI assigned

Jun 21, 2006

Last updated

Jun 24, 2009By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Prescott Urology LTD

  • Specialist
  • Prescott, AZ
  • NPI 1972549517
  Medicare reassignment NPD

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1609812247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 AINSWORTH DR",
            "address_2": "SUITE 101",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011687",
            "telephone_number": "928-771-5282",
            "fax_number": "928-771-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 AINSWORTH DR",
            "address_2": "SUITE 101",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011687",
            "telephone_number": "928-771-5282",
            "fax_number": "928-771-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANIK",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "25078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0755280",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861999",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00143552",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Stadum, NP
• Stephen Lee Stahl, O.D.
• Emily Stamper, PHARMACIST
• Ryan Standage, MSN
• Alison Eleri Stanford, FNP, RN
• Jeffrey Stayman, LPC
• Casey Trever Steele, MOTR/L
• Kristin Steele, D.M.D
• Robert Foster Steele, MA, LISAC
• Ben S Stehower

• Specialist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.