Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alexandria Noel Staub, PA-C

Individual provider Physician Assistant · NPI 1114408945

Alexandria Noel Staub, PA-C is a Physician Assistant in Klamath Falls, Oregon. Qualified in 2018, 8 years ago. Practices with Mountain West Derm - Blackhart PLLC, a 103-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
8
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1900 Main St Ste A
Klamath Falls, OR 97601-2629
Phone: (541) 382-5712
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2747 Ne Conners Ave, Bend, OR 97701-8738 — (541) 382-5712

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1114408945
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 29, 2018
Last updated in NPPESAugust 29, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Mountain West Derm - Blackhart Pllc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Klamath Falls