Individual provider Active NPI

Amy Marie Stafford, MD

  • Anesthesiology Physician
  • Louisville, KY
National Provider Identifier
1902067515
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
57445 Issued in KY
Practice address
200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone
(502) 587-4404
Fax
(502) 587-4156
NPI assigned
Jun 17, 2008
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X P2537 TX
Anesthesiology Physician 207L00000X 29337 OK
Anesthesiology Physician 207L00000X 57445 KY Primary

Addresses

Primary practice location

200 Abraham Flexner Way
Louisville, KY 40202-2877

Mailing address

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone (918) 744-3664

Other practice location 1

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone (918) 744-3664

Other identifiers 5

IdentifierTypeStateIssuer
P2537OtherTXSTATE LICENSE
7100873470MedicaidKY
300073132MedicaidIN
29337OtherOKSTATE LICENSE
8DF559OtherTXBCBS

Other names 1

  • Amy Fesler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KY2 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
I20120906000125 OK Practitioner - Anesthesiology 5799941043 Reassigns benefits to 1 organization
I20230130000649 KY Practitioner - Anesthesiology 5799941043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

3300 NW Expressway St
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29337OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Feb 1, 2023 Accepting new patients
University of Louisville Physicians, Inc. Anesthesiology Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Anesthesia Medical Professionals, PLLC Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

3300 NW Expressway St
Fl 2
Oklahoma City, OK 73112
Phone (405) 251-2815

Organizations & group practices 4

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 7

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1902067515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE",
            "address_2": "STE 217",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-587-4404",
            "fax_number": "502-587-4156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 S Utica Ave",
            "address_2": "STE 217",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741044909",
            "country_code": "US",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P2537",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "29337",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "57445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "P2537",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100873470",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300073132",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "29337",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8DF559",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FESLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.