Mark A Staffaroni, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD028793E Issued in PA

Practice address

400 N 17TH St
Ste 101
Allentown, PA 18104

Phone

(610) 433-0450

Fax

(610) 433-4655

NPI assigned

May 23, 2006

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 PA

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

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1699720375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "631-309-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 17TH ST",
            "address_2": "STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-433-0450",
            "fax_number": "610-433-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFARONI",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD028793E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219296",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Margaret Stabler, AU.D.
• Stacey L. Jones, DC
• Spencer Stack, MOTR/L
• Ross Stackhouse
• Gabrielle M. Stacy, PA-C
• Kimberly A Stagaard, SLP
• Mary Stahl-Levick, MD
• Joanna Bacelli Stahl
• Kristen Taylor Stakemann, PT
• Linda W Stambaugh, MS OTR L

• Ophthalmology Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.