Individual provider Active NPI

Stephanie Lois Leong, MD

  • Psychiatry Physician
  • Tacoma, WA
National Provider Identifier
1033190822
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-11706 Issued in HI
Practice address
9040 Jackson Ave
Tacoma, WA 98431-1700
Phone
(253) 968-3885
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 11706 HI
Psychiatry Physician 2084P0800X MD-11706 HI Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-1700

Mailing address

9040 Jackson Avenue
Tacoma, WA 98431-0001
Phone (808) 778-3203

Other names 1

  • Stephanie Lois Foster Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110000720 AK Practitioner - Psychiatry 2466829080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Uniformed Services Uhs Fe Hebert School of Med, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 459-3500

Hospital & facility affiliations

  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
79.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-11706HIMDPsychiatry Physician
11706HIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Valley Clinic LLC CurrentSince Nov 1, 2022 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Nov 1, 2022 Accepting new patients
Fairbanks Memorial Hospital, LLC Past Accepting new patients

Locations

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

1650 Cowles St
Ste 507S
Fairbanks, AK 99701

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1033190822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "808-778-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311700",
            "telephone_number": "253-968-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "STEPHANIE",
        "middle_name": "LOIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "HI",
            "license": "11706",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-11706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "FOSTER",
            "middle_name": "LOIS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.