DR. TIMOTHY STAUDACHER (M.D.) – Anesthesiology Physician, NPI 1740342435

DR. TIMOTHY STAUDACHER (M.D.) is a healthcare provider. based in Jackson, Michigan. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. 36084646 (IL). The NPI Number for DR. TIMOTHY STAUDACHER (M.D.) is 1740342435

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIMOTHY STAUDACHER (M.D.)
NPI
1740342435
Phone
(517) 787-6440
Address
255 W MICHIGAN AVE
Enumeration Date
16 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
6302084060
Graduation Year
1989 (37 years ago)
PAC ID
9739085408
Group Practice PAC ID
4587576814
Professional Enrollment ID
I20110513000327
Address ID
IL601344200GE300XXRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,631 ANESTHESIOLOGY in IL

Provider Addresses for DR. TIMOTHY STAUDACHER (M.D.)

  • 255, West Michigan Avenue, Jackson, Jackson County, Michigan, 49201, United States

    JACKSON, MI 492012218

    Phone: (517) 787-6440

    Fax: (517) 787-4146

    Type: Mailing

  • 5N144 MAPLE CT

    ST CHARLES, IL 601756259

    Phone: (630) 208-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-05-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110513000327IAnesthesiologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery260236$0
00811Anesthesia for other procedure on large bowel using an endoscope8282$0
00812Anesthesia for exam of colon using an endoscope3939$0
00813Anesthesia for procedure on small and large bowel using an endoscope2121$0
View full utilization report →

Insurance plans in this area (ZIP 49201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587576814View full group profile
NameSpecialtyState
-IL
Diagnostic Radiology, Interventional RadiologyIL
P A T H O L O G YIL
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineIL
G A S T R O E N T E R O L O G YIL
Internal MedicineIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal MedicineMN
-IL
Physical Therapist In Private PracticeIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Where can patients find DR. TIMOTHY STAUDACHER (M.D.)'s NPI?
You can confirm DR. TIMOTHY STAUDACHER (M.D.) with NPI 1740342435; it appears in the national provider directory.
Is DR. TIMOTHY STAUDACHER (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DR. TIMOTHY STAUDACHER (M.D.)?
The page reflects Anesthesiology Physician for DR. TIMOTHY STAUDACHER (M.D.). Clinical services aligned with this taxonomy classification.
Where is DR. TIMOTHY STAUDACHER (M.D.)'s primary listing?
We display Jackson, Michigan because that is what the record indicates for DR. TIMOTHY STAUDACHER (M.D.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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