Martin Harrod Staley, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS020910L Issued in PA

Practice address

334 Bloomfield Street
Suite 102
Johnstown, PA 15904

Phone

(814) 266-2312

NPI assigned

Oct 5, 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 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962598276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHERRY LANE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BLOOMFIELD STREET",
            "address_2": "SUITE 102",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "MARTIN",
        "middle_name": "HARROD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS020910L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCESS MA PROVIDER ID",
            "identifier": "0006325800003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "138959",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karyssa Sroka
• Matthew R Sroka, D.M.D.
• St Georges Lab LLC
• Alex Lee Stahl, PA-C
• Heather Stahl, PA-C
• Cynthia Stallings, CNM
• Cheryl L Stape, CRNP
• Ryan Statler, PA-C
• Sabrina Steele
• Patti Ann Stefanick, D.O., F.A.C.O.S.

• Dentist in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.