Individual provider Active NPI

James William Stavosky, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Daly City, CA
National Provider Identifier
1871548271
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3238 Issued in CA
Practice address
1800 Sullivan Ave
Suite 106
Daly City, CA 94015-2228
Phone
(650) 755-3338
Fax
(650) 755-7892
NPI assigned
May 23, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E3238 CA Primary

Addresses

Primary practice location

1800 Sullivan Ave
Suite 106
Daly City, CA 94015-2228

Mailing address

1201 Vancouver Ave
Burlingame, CA 94010-5669
Phone (650) 348-8466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090304000370 CA Practitioner - Podiatry 4789654930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1800 Sullivan Ave
Daly City, CA 94015-2224
Phone (650) 755-3338

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue285
Removal of nail tissue191
Removal or shaving of skin growth109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3238CAMDFoot & Ankle Surgery Podiatrist
3238CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James W Stavosky DPM Foot & Ankle Surgery CurrentSince Jun 30, 1984 Accepting new patients

Locations

1800 Sullivan Ave
Rm 401
Daly City, CA 94015
Phone (650) 755-3338

1500 Southgate Ave
Ste 115
Daly City, CA 94015
Phone (650) 991-4466

1800 Sullivan Ave
Rm 106
Daly City, CA 94015
Phone (650) 301-0500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1871548271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 VANCOUVER AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105669",
            "telephone_number": "650-348-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 106",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152228",
            "telephone_number": "650-755-3338",
            "fax_number": "650-755-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVOSKY",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.