Sasha O'Brien Staack, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

57561 Issued in AZ

Practice address

350 W Thomas Rd
Phoenix, AZ 85013-4409

Phone

(602) 406-3430

NPI assigned

May 25, 2017

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 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

Specialty

Diagnostic Radiology

Education

University of Arizona College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Imaging Institute Medical Group IncGroup PAC ID 1951325299, 35 clinicians

Central Valley Community Medical ImagingGroup PAC ID 5799679874, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
• Adventist Health Hanford Hospital, Hanford, CA, CCN 050121
• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Coalinga Regional Medical Center Hospital, Coalinga, CA, CCN 051338

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• California Imaging Institute Medical Group Inc

  • Radiology Clinic/Center
  • Fresno, CA
  • NPI 1497764468
  Medicare reassignment Care Compare group NPD
• Central Valley Community Medical Imaging

  dba Cmi

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1376637264
  Medicare reassignment Care Compare group NPD
• Smi Imaging, LLC

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment NPD
• Radiology Associates of San Luis Obispo, a Medical Group Inc

  • Diagnostic Radiology Physician
  • Templeton, CA
  • NPI 1326888140
  Medicare reassignment NPD
• Smi Imaging LLC

  dba Mobile Onsite Mammography

  • Mobile Mammography Clinic/Center
  • Tempe, AZ
  • NPI 1609412642
  NPD
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Orthopaedic Surgery Physician
  • San Luis Obispo, CA
  • NPI 1982462263
  NPD
• Adventist Health Heart Institute-Ukiah

  • Multi-Specialty Clinic/Center
  • Ukiah, CA
  • NPI 1417295643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Coalinga Medical Center, LLC

  dba Coalinga Regional Medical Center

  • General Acute Care Hospital
  • Coalinga, CA
  • NPI 1801452941
  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  dba Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  dba Clovis Community Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation
• Hanford Community Hospital

  dba Adventist Health Hanford

  • General Acute Care Hospital
  • Hanford, CA
  • NPI 1538141627
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1972031631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5777 E Mayo Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850544502",
            "country_code": "US",
            "telephone_number": "480-342-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122805",
            "country_code": "US",
            "telephone_number": "520-324-5096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAACK",
        "first_name": "SASHA",
        "middle_name": "O'BRIEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R76155",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "57561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstaack390018@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St. Michael's Manor
• St. Rita Hospice Inc
• Naomi Ruth St.Amand, MT-BC, NMT
• Justin Charles St.James, D.P.T
• Robert Nicholas Staab, MD
• Sara Poletti Stabenow, OTR/L
• Seth Alan Stabinsky, M.D.
• Gordon D. Stabley, D.D.S.
• Stacey D McClure MD PLLC
• Stacey Krueger Therapy LLC

• Diagnostic Radiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.