Richard D Stagl, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036066559 Issued in IL

Practice address

1713 Central St
Evanston, IL 60201

Phone

(847) 869-1499

Fax

(847) 869-2932

NPI assigned

Mar 3, 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 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment
• Cardiovascular Associates of Glenbrook and Evanston

  dba Cage

  • Legal Medicine
  • Glenview, IL
  • NPI 1023233731
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1851368328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-869-1499",
            "fax_number": "847-869-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-869-1499",
            "fax_number": "847-869-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGL",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036066559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066559",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstagl3754@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1713 Central St",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anand Srinivasan, M.D.
• St. Francis Hospital
• St. Francis Hospital OB/GYN Program
• St.Francis Hospital
• Anna Lacy Stachler, PA-C
• Gabriel Stahl, MD
• Ojhanae Stallworth
• Tequilla Stanciel, MD
• Angela M Stancy, APRN
• Jade Stanley, DR.

• Cardiovascular Disease Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.