Timothy Staudacher, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

36084646 Issued in IL

Practice address

5N144 Maple CT
St Charles, IL 60175-6259

Phone

(630) 208-3000

NPI assigned

Dec 16, 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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Anesthesiology

Education

University of Kansas School of Med (KC/Wich/Sal), 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apollo Medical Group of Illinois LLCGroup PAC ID 4880036078, 22 clinicians

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Apollo Medical Group of Illinois LLC

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1730934597
  Medicare reassignment Care Compare group NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Kane Anesthesia Associates, SC

  • Anesthesiology Physician
  • Geneva, IL
  • NPI 1568407401
  Medicare reassignment NPD
• Valley Ambulatory Surgery Center Anesthesiology LTD

  • Anesthesiology Physician
  • St Charles, IL
  • NPI 1629082326
  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Valley Ambulatory Surgery Center, LP

  dba Valley Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • St Charles, IL
  • NPI 1104819424
  NPD

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

• Delnor Community Hospital

  dba Northwestern Medicine Delnor Community Hospital

  • General Acute Care Hospital
  • Geneva, IL
  • NPI 1407859655
  Care Compare affiliation

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740342435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5N144 MAPLE CT",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756259",
            "telephone_number": "630-208-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDACHER",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "36084646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Charles Service Corporation (Olympia Chiropractic and Physical Therapy)
• St..Charles Modern Dental LLC
• Ashley Stalter
• Jennifer Stanley
• Shannon Starr
• Stephanie Clorinda Stavropoulos
• STC Dental PLLC
• Tiffany Marie Steinbraker
• Peggy Stell, P.T.
• Jennie Stellato, MOTR/L

• Anesthesiology Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• 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.

Verify at the official NPI Registry.