Individual provider Active NPI

John William Staeheli, M.D.

  • Orthopaedic Surgery Physician
  • Richland, WA
National Provider Identifier
1629059969
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD00026135 Issued in WA
Practice address
875 Swift Blvd
Richland, WA 99352-3592
Phone
(509) 946-1654
Fax
(509) 943-5652
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD00026135 WA Primary

Addresses

Primary practice location

875 Swift Blvd
Richland, WA 99352-3592

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other identifiers 3

IdentifierTypeStateIssuer
1086651MedicaidWA
134821OtherWASTATE INDUSTRIAL
MD00026135MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstaeheli1109134@wm.providencedirect.org

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

State licenses

LicenseStateTypeSpecialty
MD00026135WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Orthopaedic Associates, PLLC Orthopaedic Surgery PastSince Feb 20, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jstaeheli1109134@wm.providencedirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1629059969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523592",
            "telephone_number": "509-946-1654",
            "fax_number": "509-943-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAEHELI",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00026135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1086651",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE INDUSTRIAL",
            "identifier": "134821",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD00026135",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstaeheli1109134@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "875 Swift Blvd Ste A",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.