Stacie Lyn Patterson, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

AZ 5154 Issued in AZ

Practice address

13677 W. MC Dowell Road
201
Goodyear, AZ 85395

Phone

(623) 882-1926

Fax

(623) 882-1709

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stacie Merritt Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spatterson162946@direct.honorhealth.com

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.

• Honorhealth Ambulatory

  • Hematology & Oncology Physician
  • Scottsdale, AZ
  • NPI 1407050917
  Medicare reassignment Care Compare group
• Honorhealth Ambulatory

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1891518130
  NPD
• Scottsdale Healthcare Corp.

  • Surgery Physician
  • Scottsdale, AZ
  • NPI 1255586483
  NPD
• Honorhealth Ambulatory

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Scottsdale, AZ
  • NPI 1053881938

  Medical

  NPD (past)
• Honorhealth Ambulatory

  • Cardiovascular Disease Physician
  • Scottsdale, AZ
  • NPI 1275833915

  Medical

  NPD (past)
• Gynecology and Holistic Care PC

  • Obstetrics & Gynecology Physician
  • Clinton Township, MI
  • NPI 1205011319

  Physician Assistant

  NPD (past)

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

• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1811951429
  Care Compare affiliation

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1053430876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 W. MC DOWELL ROAD",
            "address_2": "STE 201",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85395",
            "telephone_number": "623-882-1926",
            "fax_number": "623-882-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 W. MC DOWELL ROAD",
            "address_2": "201",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85395",
            "telephone_number": "623-882-1926",
            "fax_number": "623-882-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "STACIE",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004376",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "AZ 5154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F37698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "MERRITT",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pathways Assisted Living & Memory Care, LLC
• Pathways Assisted Living and Memory Care, LLC
• Pathways Assisted Living and Memory Care, LLC
• Pathways Assisted Living and Memory Care, LLC
• Kyle James Patterson, PHARMD
• Paul S. Charnetsky, M.D. P.C.
• Loveleen Paul, DO
• Jeffrey Paulus
• Marie Pavese, M.D.
• Jennifer Kaye Paweleck-Bellingrodt, PSY.D.

• Surgical Physician Assistant in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.