Jason Staback, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MP00051300 Issued in NJ

Practice address

17644 Coastal Hwy #6
Lewes, DE 19958

Phone

(877) 425-7756

NPI assigned

May 11, 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 3

Medicare fee-for-service enrollment

Enrolled in NJ, NY, DE3 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clearsolutions Dermatology Group New JerseyGroup PAC ID 2466890025, 2 clinicians

Clearsolutions Dermatology GroupGroup PAC ID 4981078953, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Clearsolutions Dermatology Group

  • Dermatology Physician
  • Lewes, DE
  • NPI 1013626753
  Medicare reassignment Care Compare group Authorized official
• Clearsolutions Dermatology Group New Jersey

  • Dermatology Physician
  • Manchester Township, NJ
  • NPI 1831977024
  Medicare reassignment Care Compare group Authorized official
• Clearsolutions Dermatology Group Florida

  • Dermatology Physician
  • Miami, FL
  • NPI 1902684194
  NPD Authorized official
• Patricia C McCormack MD PC

  • Dermatology Physician
  • Point Pleasant Beach, NJ
  • NPI 1700184884

  NY

  Medicare reassignment
• Insight Diagnostics LLC

  • Clinical Laboratory Director (Non-physician)
  • Lewes, DE
  • NPI 1457168098
  NPD (past) Authorized official
• Rami E Geffner MD PA

  • Dermatology Physician
  • Toms River, NJ
  • NPI 1326098559
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1750331948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17644 COASTAL HWY #6",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "877-425-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17644 COASTAL HWY #6",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "877-425-7756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 Commons Way Bldg B",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087556427",
            "country_code": "US",
            "telephone_number": "973-625-0600 x213",
            "fax_number": "973-625-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1616 Route 72 W Ste 2",
            "address_purpose": "LOCATION",
            "city": "Manahawkin",
            "state": "NJ",
            "postal_code": "080505131",
            "country_code": "US",
            "telephone_number": "973-625-0600 x213",
            "fax_number": "697-625-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 Kearny Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Kearny",
            "state": "NJ",
            "postal_code": "070322942",
            "country_code": "US",
            "telephone_number": "973-625-0600 x213",
            "fax_number": "973-625-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 Clifton Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070132724",
            "country_code": "US",
            "telephone_number": "973-625-0600 x213",
            "fax_number": "973-625-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Green Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rockaway",
            "state": "NJ",
            "postal_code": "078662052",
            "country_code": "US",
            "telephone_number": "973-625-0600 x213",
            "fax_number": "973-625-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Centurian Dr",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132137",
            "country_code": "US",
            "telephone_number": "877-425-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STABACK",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MP00051300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID/AMERIGROUP",
            "identifier": "320525",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "0161662",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K5491",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Woodard Springle, RN
• Springpoint at Lewes, Inc.
• Springpoint at Lewes, Inc.
• Michele Sprinkle, BSN
• Deborah Staats, RN
• Stephanie Staehle, RN
• Ann Marie Stafford, CNM
• Belynda Faye Stafford, RN
• Heather Stalters, RN
• Joyce Stambaugh, RN

• Dermatology Physician in Lewes, DE
• Providers in Lewes, DE by specialty
• Dermatology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.