Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Patrick Staidle, MD

Individual provider MOHS-Micrographic Surgery Physician · NPI 1982994455

Jonathan Patrick Staidle, MD is a Dermatology in Sparks, Nevada. Graduated from Northeastern Ohio University College of Medicine in 2011, 15 years ago. Practices with Mountain West Derm - Blackhart PLLC, a 103-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Ohio and Pennsylvania.

Years since qualifying
15
Trained at
Northeastern Ohio University College of Medicine
Licensed in
OH, PA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4814 Sparks Blvd
Sparks, NV 89436-8219
Phone: (775) 327-0699
Fax: (775) 451-7501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 607 S Maine St, Fallon, NV 89406-3801 — (775) 324-0699
  • 640 W Moana Ln, Reno, NV 89509-4903 — (775) 324-0699

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 35-126612 (OH)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence MD457066 (PA)

Record details

NPI number1982994455
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2011
Last updated in NPPESJanuary 19, 2021
Certification dateJanuary 19, 2021
Mailing address640 W Moana Ln, Reno, NV 89509-4903

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Mountain West Derm - Blackhart Pllc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount