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THEODORE EDMUND STAAHL M.D.
NPI 1295896041
Specialist in Modesto, CA

Active since December 13, 2006Accepts Medicare Assignment
1329 SPANOS CT STE A-1, MODESTO, CA 95355(209) 577-5700(209) 577-5968 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Theodore Edmund Staahl M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE EDMUND STAAHL M.D. (NPI 1295896041) is an individual specialist in Modesto, California, licensed in California (G037452) and active in the NPI registry since December 2006. He is a graduate of Other (1971).

NPPES Registry Identity

NPI1295896041
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameTHEODORE EDMUND STAAHLCredential: M.D.
Location Address1329 SPANOS CT STE A-1Modesto, CA 95355-2806
Mailing Address1329 Spanos Ct Ste A-1Modesto, CA 95355-2806 · (209) 577-5700 · Fax (209) 577-5968
Phone(209) 577-5700
Fax(209) 577-5968
Sole ProprietorYes
Medical School CMSOtherGraduated 1971
Enumeration DateDecember 13, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1295896041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · G037452
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1329 SPANOS CT STE A-1, Modesto, CA 95355
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Other Identifiers 1

Medicare UPINA47096CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theodore Edmund Staahl M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800080466
PECOS Enrollment IDI20101028000427

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
31 services31 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Staahl's NPI number?

The NPI number for Theodore Staahl is 1295896041. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Theodore Staahl located?

Theodore Staahl practices at 1329 Spanos Ct Ste A-1, Modesto, CA 95355. The listed phone number is (209) 577-5700.

What is Theodore Staahl's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Theodore Staahl enrolled in Medicare?

Yes. Theodore Staahl is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Theodore Staahl was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.