MEDICARE: STAFFEL G OATES CRNA

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	4462	WI
2	367500000X	Certified Registered Nurse Anesthetist	AP112834	TX
3	367500000X	Certified Registered Nurse Anesthetist	RN9164854	FL
4	367500000X	Certified Registered Nurse Anesthetist	ARNP9164854	FL
5	367500000X	Certified Registered Nurse Anesthetist	1839	SC
6	207L00000X	Anesthesiology Physician	D128043	IA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	G2598	OTHER	FL	BCBS
6	P01707891	OTHER	TX	RR
7	8960UM	OTHER	TX	BCBS

NPI Number	:	1033223375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STAFFEL G OATES CRNA

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	1500 CITYWEST BLVD
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77042-2300
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:	972-715-9976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	04/17/2026