Individual provider Active NPI

John Stanievich Jr., PA

  • Surgical Physician Assistant
  • Eugene, OR
National Provider Identifier
1932659992
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA175347 Issued in OR
Practice address
55 Coburg Rd
Eugene, OR 97401-2433
Phone
(541) 485-8111
NPI assigned
Oct 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA175347 OR Primary

Addresses

Primary practice location

55 Coburg Rd
Eugene, OR 97401-2433

Mailing address

55 Coburg Rd
Eugene, OR 97401-2433
Phone (541) 485-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606003346 WA Practitioner - Physician Assistant 1153686464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 426-6341

1608 S J St
Tacoma, WA 98405-4930

1617 S J St
Tacoma, WA 98405-4930
Phone (253) 426-6306

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (564) 240-1000

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

34503 9TH Ave S
Federal Way, WA 98003-8726

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 944-7977

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA175347ORMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Apr 29, 2018 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

16122 8th Ave SW
Ste D1
Burien, WA 98166
Phone (206) 241-7146

16259 Sylvester Rd SW
Ste 401
Burien, WA 98166
Phone (206) 242-8837

34509 9th Ave S
Ste 204
Federal Way, WA 98003
Phone (253) 835-5510

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

2920 S Meridian
Ste 100
Puyallup, WA 98373
Phone (253) 604-4599

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1802 Yakima Ave
Ste 202
Tacoma, WA 98405
Phone (253) 383-5949

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1932659992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANIEVICH",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA175347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.