JUSTIN STAFFORD (PA-C) – Physician Assistant, NPI 1083168454
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
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Provider Addresses for JUSTIN STAFFORD (PA-C)
3533, Southern Boulevard, South Dale, Kettering, Montgomery County, Ohio, 45429, United States
SUITE 2100
KETTERING, OH 454291264
Phone: (937) 395-8556
Fax: (937) 522-7873
Type: Mailing
Kettering Medical Center, 3535, Southern Boulevard, Kettering, Montgomery County, Ohio, 45429, United States
KETTERING, OH 454291221
Phone: (937) 395-6020
Fax: (937) 522-7873
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.
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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: 2016-09-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160928002547 | I | Physician Assistant | OH | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 32555 | Aspiration of fluid from chest cavity using imaging guidance | 33 | 31 | $0 |
| 49083 | Drainage of fluid from abdominal cavity using imaging guidance | 29 | 26 | $0 |
Insurance plans in this area (ZIP 45429)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | OH | |
| Physician Assistant | OH | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MN |
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