Individual provider Active NPI

Stacey L Milani, MD

  • Pediatrics Physician
  • Pleasant Hill, IA
National Provider Identifier
1104935188
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35885 Issued in IA
Practice address
5900 E University Ave
Suite 300
Pleasant Hill, IA 50327-8457
Phone
(515) 643-2600
Fax
(515) 643-4733
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35885 IA Primary

Addresses

Primary practice location

5900 E University Ave
Suite 300
Pleasant Hill, IA 50327-8457

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-2600

Other identifiers 1

IdentifierTypeStateIssuer
0451914MedicaidIA

Other names 1

  • Stacey L George Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20130724000228 IA Practitioner - Pediatric Medicine 7911963186 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35885IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Mercy Clinics, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

1601 NW 114th St
Ste 345
Des Moines, IA 50325
Phone (515) 222-7337

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

5900 E University Ave
Ste 300
Pleasant Hill, IA 50327
Phone (515) 623-2600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1104935188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-2600",
            "fax_number": "515-643-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 E UNIVERSITY AVE",
            "address_2": "SUITE 300",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278457",
            "telephone_number": "515-643-2600",
            "fax_number": "515-643-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANI",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "35885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0451914",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "GEORGE",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pleasant Hill, IA

Sources for this page

Verify at the official NPI Registry.