Individual provider Active NPI

Jonathan M Staben, MD

  • Family Medicine Physician
  • Cheney, WA
National Provider Identifier
1720071889
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00041531 Issued in WA
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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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 2,312 clinicians

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 Home health agency, Spokane Valley, WA, CCN 507130
  • Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Skin biopsy1-10

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
MD00041531WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 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

  • Direct secure messaging: jstaben330820@direct.multicare.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00041531 WA Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
8356818MedicaidWA

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

Verify at the official NPI Registry.