John H Stadick, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

992 Issued in AZ

Practice address

1700 Cerrillos Rd
Santa Fe, NM 87505-3554

Phone

(505) 988-9821

NPI assigned

Dec 28, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Santa Fe Indian Hospital

  • Federal Public Health Clinic/Center
  • Santa Fe, NM
  • NPI 1285613836

  TX

  Medicare reassignment NPD
• Santo Domingo Health Clinic

  • General Acute Care Hospital
  • Santo Domingo Pueblo, NM
  • NPI 1376632695
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1689651978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053554",
            "telephone_number": "505-946-9219",
            "fax_number": "505-983-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053554",
            "telephone_number": "505-988-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADICK",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A6452",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Vincent Hospital
• St. Vincent Hospital
• Shona Stack, RN
• Uli E Stack
• Savannah L Stadelmaier, DDS
• James Ingraham Stake, MA, PHIL
• Katrina Stamas, CF-SLP
• Robert Brad Stamm, MD
• April D Stamper, MSW
• Michelangelo Stanchi

• All providers in Santa Fe, NM
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.