Individual provider Active NPI

Joseph Staffetti

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1629697222
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036170795 Issued in IL
Practice address
1725 W Harrison St
Chicago, IL 60612-3841
Phone
(312) 942-4500
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 036170795 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Chicago, IL 60612-3841

Mailing address

1725 W Harrison St
Chicago, IL 60612-3841
Phone (312) 942-4500

Other practice location 1

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (727) 612-3775

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
Suite 62
Tampa, FL 33612-4799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036170795ILMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1629697222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Davis Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063438",
            "country_code": "US",
            "telephone_number": "727-612-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFETTI",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036170795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.