Coleen Staloch, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0041 Issued in ND

Practice address

310 N 9TH St
Bismarck, ND 58501-4508

Phone

(701) 530-8800

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Coleen Humann Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

79.67 of 100Reported as group

Quality

80.89

Promoting interoperability

71

Improvement activities

40

Cost

75.49

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

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 and National Provider Directory roles.

• Bone and Joint Center, PC

  • Body Imaging Physician
  • Bismarck, ND
  • NPI 1114947678
  NPD
• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1609938182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014515",
            "telephone_number": "701-530-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014508",
            "telephone_number": "701-530-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALOCH",
        "first_name": "COLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R19160",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27445",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLEEN",
            "last_name": "HUMANN",
            "credential": "PA, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gale C Stahl, BS LAC
• Michelle A Stahl
• Nigeria M Stahl, MD
• Joshua J Staiger, CRNA
• Catherine Elizabeth Staloch, PT
• Megan Stamstad, PT, DPT
• John G Stanley, M.D., D.M.D.
• Miranda Dawn Stanley, FNP
• Bears Star
• Noribelle Starck

• Physician Assistant in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.