Individual provider Active NPI

Jeffrey S Staron, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Munster, IN
National Provider Identifier
1780723122
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
01066936A Issued in IN
Practice address
8141 Calumet Ave Unit 1
Munster, IN 46321-1701
Phone
(219) 961-9480
Fax
(630) 718-6057
NPI assigned
Feb 5, 2007
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036139164 IL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 01066936A IN Primary

Addresses

Primary practice location

8141 Calumet Ave Unit 1
Munster, IN 46321-1701

Mailing address

8141 Calumet Ave Unit 1
Munster, IN 46321-1701
Phone (219) 961-9480

Other practice location 1

951 Essington Rd Ste 1
Joliet, IL 60435-8441
Phone (815) 744-4551

Other identifiers 1

IdentifierTypeStateIssuer
1669472270OtherINNPI GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110826000681 IN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2365612439 Reassigns benefits to 1 organization
I20160421002015 IL Practitioner - Orthopedic Surgery 2365612439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

10110 Donald S Powers Dr
Suite 101B
Munster, IN 46321-4070
Phone (219) 961-9480

1870 Silver Cross Blvd
New Lenox, IL 60451-8639
Phone (815) 462-3474

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Oct 1, 2020 Accepting new patients
Hinsdale Orthopaedic Associates, SC CurrentSince Aug 1, 2018 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Oct 1, 2020 Accepting new patients
Hinsdale Orthopaedic Associates, S.C. PastSince Dec 5, 2018 Accepting new patients
Great Lakes Orthopedics and Sports Medicine, P.C. Past Accepting new patients
Great Lakes Orthopedics & Sports Medicine, PC Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

951 Essington Rd
Ste 1
Joliet, IL 60435
Phone (815) 744-4551

1870 Silver Cross Blvd
Ste 200
New Lenox, IL 60451
Phone (630) 323-6116

1870 Silver Cross Blvd
Ste 240
New Lenox, IL 60451
Phone (630) 873-8889

10110 Donald S Powers Dr
Ste 101B
Munster, IN 46321
Phone (219) 961-8480

8141 Calumet Ave
Munster, IN 46321
Phone (219) 961-8480

8141 Calumet Ave
Unit 1
Munster, IN 46321
Phone (219) 961-9480

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10531/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jstaron82912@direct.franciscanalliance.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1780723122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 CALUMET AVE UNIT 1",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-961-9480",
            "fax_number": "630-718-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8141 CALUMET AVE UNIT 1",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-961-9480",
            "fax_number": "630-718-6057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Essington Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604358441",
            "country_code": "US",
            "telephone_number": "815-744-4551",
            "fax_number": "630-718-6057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARON",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036139164",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "01066936A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1669472270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.