Active NPI
Jonathan M Staben, MD
- Family Medicine Physician
- Cheney, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00041531
- Practice address
- 19 N 7TH St
Cheney, WA 99004-2220 - Phone
- (509) 838-2531
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Tacoma, WA
- NPI 1063711562
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Spokane Valley, WA
- NPI 1588212641
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Multicare Health System
Practice addresses (Care Compare)
19 N 7TH St
Cheney, WA 99004-2220
Phone (509) 235-6151
311 S L St
Tacoma, WA 98405-3720
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
Hospital & facility affiliations
- Eden Home Health
- Deaconess Medical Center
- Tacoma General Allenmore Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 11 |
| Skin biopsy | 1-10 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040723001110 | WA | Practitioner - Family Practice | 3577543057 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00041531 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Family Medicine | Past | Accepting new patients |
Locations
19 N 7th St
Cheney, WA 99004
Phone (509) 235-6151
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Interoperability endpoints
- jstaben330820@direct.multicare.org
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00041531 | WA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
19 N 7TH St
Cheney, WA 99004-2220
Mailing address
PO Box 3649
Spokane, WA 99220-3649
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8356818 | Medicaid | WA |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 15, 2008.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229299200000",
"number": "1720071889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3649",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 N 7TH ST",
"city": "CHENEY",
"state": "WA",
"postal_code": "990042220",
"telephone_number": "509-838-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STABEN",
"first_name": "JONATHAN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2008-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00041531",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8356818",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cheney, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.
- 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.