Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1932174497 Individual Practitioner Male Practitioner

Dr. Charles L Stackhouse , MD

Surgery • Clifton Springs, NY

Professional Overview & Biography Verified Profile Summary

Dr. Charles Stackhouse, MD is a registered healthcare professional specializing in Surgery in Clifton Springs, NY. Practice services are available at 4 COULTER RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4 Coulter Rd

Clifton Springs, NY 144321122

Telephone 3154622636
Fax 3154622638
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Clifton Springs, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 27.5 Yrs
State Avg: 27.8 Yrs
Regional Practice Density
3 Specialists

Practicing in Clifton Springs, NY (2269 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NY 1430991

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License NY 143099

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
00835396 (NY)

Practice Associates & Co-Workers

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

6 Associated Practitioners
Karen Maloney , RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1013510734
NPI 1114987989

Doctor of Medicine (M.D.)

Kerri Dejonge , RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1174126999
NPI 1326152489

Doctor of Medicine (M.D.)

Jana Cooper-Slifko , NP

Nurse Practitioner - Family

NPI 1558510289

Nurse Practitioner

Yvonne Goldman , RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1699370171

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 13, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location June 13, 2013

Registered at 4 COULTER RD, CLIFTON SPRINGS, NY 144321122 (Tel: 3154622636)

📍
Updated Business Mailing Address June 13, 2013

Registered at 4567 CROSSROADS PARK DR, LIVERPOOL, NY 130883589 (Tel: 3152952100)

👤
Provider Name / Credentials Updated June 13, 2013

Recorded as CHARLES STACKHOUSE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 13, 2013

Surgery (License #1430991 in NY)

🟢
Initial NPI Registration & Enumeration February 20, 2006

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: 1932174497
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 20, 2006
Last Update: June 13, 2013
Sole Proprietor: Yes

Mailing Address

4567 Crossroads Park Dr

Liverpool, NY 130883589

Phone: 3152952100

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.