Active NPI 1982994455 Individual Practitioner Male Practitioner

Dr. Jonathan Patrick Staidle , MD

Dermatology • Sparks, NV

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Staidle, MD is a certified Dermatology practicing in Sparks, NV. With approximately 15 years of clinical experience since graduating from Northeastern Ohio University College Of Medicine in 2011, Dr. Staidle delivers high-quality medical care to the local community at 4814 SPARKS BLVD.

Dr. Staidle is affiliated with Mountain West Derm - Blackhart Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks, removal and microscopic exam of growth of head, neck, hands, feet, or genitals. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4814 Sparks Blvd

Sparks, NV 894368219

Telephone 7753270699

Fax 7754517501

Associated Practice Facility / Clinic

🏢 Skin Cancer And Dermatology Institute Facility NPI 1003905001

Medicare Profile & Education

Medical School

Northeastern Ohio University College Of Medicine

Graduation Year

2011

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Sparks, NV

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

15 Yrs Matches City Avg

City Avg: 15.0 Yrs

State Avg: 19.7 Yrs

Regional Practice Density

3 Specialists

Practicing in Sparks, NV (93 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

61.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Staidle (15 Years) 15 Yrs

Sparks Specialty Average (15.0 Years) 15.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	875	110	$14.82	$6.55
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	358	314	$1402.83	$573.33
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	338	217	$847.58	$403.93
99213 Established patient office or other outpatient visit, typically 15 minutes	269	214	$187.84	$89.00
17000 Destruction of skin growth	158	133	$159.14	$53.89
17004 Destruction of precancer skin growth, 15 or more growths	89	64	$350.57	$164.57
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	86	80	$1167.22	$247.93
17110 Destruction of up to 14 skin growths	69	64	$235.58	$107.04
11102 Tangential biopsy of single skin lesion	62	53	$214.30	$92.09
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	56	55	$643.80	$280.01
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	53	31	$810.46	$386.85
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	50	49	$1646.20	$742.81
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	47	39	$1311.78	$605.95
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	42	42	$659.04	$187.57
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	40	39	$526.52	$117.05
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	40	40	$905.62	$243.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	29	$115.22	$55.50
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	34	18	$3.58	$0.96
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	33	32	$770.92	$263.99
11900 Injection into skin growth, 1-7 growths	29	19	$118.01	$53.46
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	26	24	$702.66	$308.36
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	23	$576.03	$131.38
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	21	19	$378.32	$163.46
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	19	19	$647.12	$223.41
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	18	$601.13	$151.57
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	17	17	$1129.85	$298.41
11103 Biopsy of related skin growth, each additional growth	17	11	$112.09	$49.17
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	17	17	$1614.78	$742.62
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	16	14	$282.19	$123.28
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	15	15	$544.19	$123.60
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	14	14	$2149.00	$977.44
69100 Biopsy of ear	12	11	$214.02	$73.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	991	135	$14.82	$6.73
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	369	322	$1402.83	$588.53
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	358	236	$847.58	$411.46
99213 Established patient office or other outpatient visit, typically 15 minutes	288	223	$187.84	$90.02
17000 Destruction of skin growth	202	163	$159.14	$51.69
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	146	139	$1167.22	$270.35
11102 Tangential biopsy of single skin lesion	93	82	$214.30	$92.23
17110 Destruction of up to 14 skin growths	89	77	$235.58	$110.37
17004 Destruction of precancer skin growth, 15 or more growths	71	59	$350.57	$171.09
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	61	58	$905.62	$258.90
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	49	48	$643.80	$296.40
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	43	41	$526.52	$123.71
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	42	42	$1646.20	$775.56
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	34	$115.22	$55.63
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	35	34	$659.04	$224.27
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	30	27	$1311.78	$621.65
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	28	28	$1614.78	$767.04
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	26	19	$810.46	$398.10
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	22	22	$647.12	$249.63
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	21	20	$601.13	$147.90
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	20	19	$576.03	$135.40
11103 Biopsy of related skin growth, each additional growth	18	15	$112.09	$50.88
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	17	17	$544.19	$142.81
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	16	16	$1129.85	$251.71
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	13	13	$378.32	$169.88
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	13	12	$702.66	$326.10
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	12	12	$2001.28	$930.59
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	12	12	$282.19	$129.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$231.74	$112.56
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	11	11	$770.92	$302.39
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	11	11	$844.02	$403.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	816	148	$14.82	$6.92
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	283	242	$1402.83	$579.08
99213 Established patient office or other outpatient visit, typically 15 minutes	278	220	$187.84	$93.13
17000 Destruction of skin growth	226	186	$159.14	$55.25
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	219	156	$847.58	$419.04
11102 Tangential biopsy of single skin lesion	102	91	$214.30	$90.99
17110 Destruction of up to 14 skin growths	101	81	$235.58	$112.31
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	82	76	$1167.22	$271.08
17004 Destruction of precancer skin growth, 15 or more growths	72	55	$350.57	$174.38
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	51	46	$115.22	$57.87
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	50	50	$1646.20	$782.63
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	40	40	$659.04	$207.02
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	40	40	$905.62	$261.20
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	36	30	$1311.78	$651.58
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	36	34	$643.80	$293.76
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	33	11	$3.58	$1.15
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	25	24	$1614.78	$785.33
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	22	$526.52	$126.85
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	25	15	$810.46	$404.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$231.74	$112.63
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	20	$576.03	$146.47
11103 Biopsy of related skin growth, each additional growth	21	16	$112.09	$53.21
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	19	19	$1129.85	$259.93
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	16	$601.13	$153.94
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$647.12	$271.12
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	14	13	$770.92	$287.15
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	11	11	$544.19	$143.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	968	144	$14.82	$6.67
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	306	261	$1402.83	$585.29
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	299	183	$846.98	$422.36
17000 Destruction of skin growth	223	180	$159.14	$52.62
Q4196 Puraply am, per square centimeter	195	11	$122.01	$106.73
99213 Established patient office or other outpatient visit, typically 15 minutes	176	145	$185.88	$94.11
17110 Destruction of up to 14 skin growths	113	98	$235.58	$115.09
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	108	98	$112.18	$57.84
11102 Tangential biopsy of single skin lesion	94	79	$213.96	$95.16
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	82	77	$1167.22	$299.57
17004 Destruction of precancer skin growth, 15 or more growths	62	53	$350.57	$170.58
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	53	51	$1646.20	$787.49
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	46	43	$905.62	$286.49
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	42	40	$658.18	$213.73
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	35	19	$3.58	$1.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	34	34	$231.74	$116.53
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	31	30	$643.80	$290.67
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	30	29	$576.03	$138.35
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	29	28	$526.52	$133.85
11900 Injection into skin growth, 1-7 growths	28	21	$118.01	$55.50
11103 Biopsy of related skin growth, each additional growth	27	18	$112.09	$52.95
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	26	24	$1614.78	$791.56
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	24	24	$1129.85	$287.62
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	21	20	$647.12	$255.82
99202 New patient office or other outpatient visit, typically 20 minutes	18	18	$157.18	$75.55
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	14	$370.42	$136.54
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	16	14	$1311.78	$659.25
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	13	$544.19	$143.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	6,200	31	$2.75	$1.43
17003 Destruction of precancer skin growth, 2-14 growths	850	122	$14.81	$6.17
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	356	219	$824.65	$408.02
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	331	281	$1401.75	$570.77
17000 Destruction of skin growth	201	158	$159.06	$52.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	114	$225.41	$111.99
11102 Tangential biopsy of single skin lesion	115	101	$207.85	$93.89
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	105	101	$1166.57	$277.37
17110 Destruction of up to 14 skin growths	91	75	$235.48	$110.14
99213 Established patient office or other outpatient visit, typically 15 minutes	90	78	$153.30	$74.91
17004 Destruction of precancer skin growth, 15 or more growths	66	51	$350.48	$163.25
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	63	63	$1644.66	$793.51
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	49	$91.77	$46.78
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	56	52	$904.67	$291.59
11103 Biopsy of related skin growth, each additional growth	45	28	$112.09	$52.96
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	42	22	$3.58	$1.43
11900 Injection into skin growth, 1-7 growths	39	27	$118.02	$50.33
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	38	36	$643.48	$285.45
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	31	30	$526.20	$120.11
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	30	30	$287.92	$135.81
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	29	27	$576.04	$140.76
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	26	25	$1614.79	$791.03
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	23	23	$623.04	$227.43
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	21	21	$612.68	$268.11
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	18	$543.63	$146.58
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	18	18	$1128.63	$263.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$226.81	$111.04
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	16	12	$792.01	$395.03
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	16	14	$370.43	$148.80
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	14	$601.13	$149.53
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	15	15	$1311.79	$645.61
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	14	14	$817.15	$203.24
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$156.97	$78.23
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	13	13	$2001.28	$965.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	12,400	61	$2.75	$1.42
17003 Destruction of precancer skin growth, 2-14 growths	925	139	$14.54	$5.59
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	343	203	$809.10	$395.48
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	304	266	$1375.32	$555.84
17000 Destruction of skin growth	216	173	$156.02	$51.41
99213 Established patient office or other outpatient visit, typically 15 minutes	155	127	$150.36	$74.35
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	152	144	$1144.34	$317.49
11102 Tangential biopsy of single skin lesion	108	91	$203.84	$91.54
17110 Destruction of up to 14 skin growths	103	84	$230.96	$107.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	98	80	$221.02	$109.44
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	83	37	$3.58	$1.59
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	72	67	$1613.92	$775.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	68	62	$90.00	$45.02
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	63	58	$887.86	$330.22
17004 Destruction of precancer skin growth, 15 or more growths	59	42	$343.70	$152.30
11900 Injection into skin growth, 1-7 growths	59	39	$115.70	$48.77
96574 Application of light with debridement to destroy precancer skin growth	48	47	$757.84	$260.80
11103 Biopsy of related skin growth, each additional growth	31	23	$109.89	$52.56
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	29	27	$564.74	$147.43
99202 New patient office or other outpatient visit, typically 20 minutes	26	26	$154.10	$72.68
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	24	23	$823.32	$407.30
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	23	22	$516.20	$131.54
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$222.36	$109.14
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	19	$533.52	$142.70
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	18	$363.16	$138.68
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	19	12	$776.48	$384.35
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	16	$589.34	$143.95
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	17	17	$1107.70	$288.53
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	15	15	$801.12	$264.11
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	15	15	$1583.12	$695.48
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	14	14	$283.38	$126.19
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	13	12	$1286.06	$634.23
13151 Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm	12	12	$877.10	$198.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,327	176	$14.54	$5.18
17000 Destruction of skin growth	297	222	$156.02	$49.15
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	214	125	$809.10	$394.03
99213 Established patient office or other outpatient visit, typically 15 minutes	203	155	$150.36	$73.02
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	178	161	$1375.32	$521.95
17110 Destruction of up to 14 skin growths	151	135	$230.96	$108.78
11100 Biopsy of single growth of skin and/or tissue	148	131	$215.02	$93.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	139	139	$222.36	$107.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	114	90	$90.00	$44.24
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	89	40	$3.58	$1.78
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	87	79	$1144.34	$337.73
99202 New patient office or other outpatient visit, typically 20 minutes	84	84	$154.10	$75.88
17004 Destruction of precancer skin growth, 15 or more growths	71	51	$343.70	$146.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	48	$221.02	$105.92
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	49	48	$1613.92	$779.61
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	40	37	$887.86	$347.05
11900 Injection into skin growth, 1-7 growths	36	32	$115.70	$51.60
11101 Biopsy of each additional growth of skin and/or tissue	29	22	$67.76	$33.05
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	23	22	$589.34	$157.06
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	22	20	$823.32	$365.61
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	20	$564.74	$144.53
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	20	$516.20	$132.61
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	19	18	$631.18	$307.83
69100 Biopsy of ear	14	14	$209.82	$84.23
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	13	13	$1583.12	$772.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	312	68	$14.53	$5.77
17000 Destruction of skin growth	97	85	$156.02	$50.28
11100 Biopsy of single growth of skin and/or tissue	64	62	$215.02	$96.79
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	63	39	$809.10	$398.08
99213 Established patient office or other outpatient visit, typically 15 minutes	55	51	$150.36	$74.01
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	48	$90.00	$44.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$222.36	$108.25
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	52	48	$1375.32	$507.50
17110 Destruction of up to 14 skin growths	36	35	$230.96	$108.94
99202 New patient office or other outpatient visit, typically 20 minutes	35	35	$154.10	$75.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	25	$221.02	$108.82
11101 Biopsy of each additional growth of skin and/or tissue	12	12	$67.76	$33.34
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	12	12	$1144.33	$283.95
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	11	11	$1583.12	$778.89
17004 Destruction of precancer skin growth, 15 or more growths	11	11	$343.70	$153.51
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$1613.92	$794.05

Medical Specialties & State Licenses

CMS Verified: 2021-01-19

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License OH 35-126612

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology - MOHS-Micrographic Surgery

NUCC Taxonomy Code: 207ND0101X

State License PA MD457066

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0129749 (OH)

Hospital & Practice Group Affiliations

Mountain West Derm - Blackhart Pllc

3640 Warren Way, Reno, NV 895095240

Phone: 7753240699

Secondary Practice Locations

640 W Moana Ln

Reno, NV 895094903

Phone: 7753240699

607 S Maine St

Fallon, NV 894063801

Phone: 7753240699

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Irene Mannering , MD

Dermatology

NPI 1023300977

Doctor of Medicine (M.D.)

Dr. Michael Heaphy , MD

Dermatology - Dermatopathology

NPI 1174620496

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location January 19, 2021

Registered at 4814 SPARKS BLVD, SPARKS, NV 894368219 (Tel: 7753270699)

📍

Updated Business Mailing Address January 19, 2021

Registered at 640 W MOANA LN, RENO, NV 895094903 (Tel: 7753240699)

✅

NPI Profile Active May 02, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location May 02, 2017

Registered at 2221 GARRETT RD, DREXEL HILL, PA 190261101 (Tel: 6106235885)

📍

Updated Business Mailing Address May 02, 2017

Registered at 2221 GARRETT RD, DREXEL HILL, PA 190261101 (Tel: 6106235885)

👤

Provider Name / Credentials Updated May 02, 2017

Recorded as JONATHAN STAIDLE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2017

Dermatology (License #35-126612 in OH)

✅

NPI Profile Active July 28, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location July 28, 2015

Registered at 725 UNIVERSITY BLVD, FAIRBORN, OH 45435 (Tel: 9372247546)

📍

Updated Business Mailing Address July 28, 2015

Registered at 725 UNIVERSITY BLVD, FAIRBORN, OH 45435 (Tel: 9372457100)

👤

Provider Name / Credentials Updated July 28, 2015

Recorded as JONATHAN STAIDLE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2015

Dermatology (License #35-126612 in OH)

🟢

Initial NPI Registration & Enumeration April 18, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982994455

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 18, 2011

Last Update: January 19, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

640 W Moana Ln

Reno, NV 895094903

Phone: 7753240699

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.