Angie Leigh Staller, M.D

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

S1284 Issued in TX

Practice address

6410 Fannin St Ste 420
Houston, TX 77030-3007

Phone

(832) 325-7280

Fax

(713) 512-7104

NPI assigned

Apr 28, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Angie Leigh Busch Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Urology

Education

University of Texas Medical School at Houston, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
• Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: astaller66851@memorialhermann.direct-ci.com
• Direct secure messaging: angie.staller@direct.memorialhermann.org

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.

• Memorial Hermann Medical Group

  • Family Medicine Physician
  • Fulshear, TX
  • NPI 1003985102

  Urology

  Medicare reassignment Care Compare group NPD

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

• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1013948553

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • The Woodlands, TX
  • NPI 1275564858

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1407959448

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Houston, TX
  • NPI 1437189115

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Friendswood, TX
  • NPI 1508896267

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Pearland, TX
  • NPI 1669402335

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1730132234
  Care Compare affiliation
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1982666111
  Care Compare affiliation

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1790195907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 CHELTENHAM DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770962929",
            "telephone_number": "281-686-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 420",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303007",
            "telephone_number": "832-325-7280",
            "fax_number": "713-512-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLER",
        "first_name": "ANGIE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "S1284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angie.staller@direct.memorialhermann.org",
            "affiliation": "N",
            "address_1": "250 Blossom St Ste 220",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775984243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGIE",
            "last_name": "BUSCH",
            "middle_name": "LEIGH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Kenneth Stalling, LCSW
• Simone Stalling, MD
• Lakayla Stallings
• Stallion Design LLC

• Urology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.