Individual provider Active NPI

Stephanie M. Simonson, MD

  • Diagnostic Radiology Physician
  • Spokane, WA
National Provider Identifier
1124177043
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60995156 Issued in WA
Practice address
801 S Stevens St
Spokane, WA 99204-2654
Phone
(509) 747-4455
Fax
(509) 363-7064
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60995156 WA Primary

Addresses

Primary practice location

801 S Stevens St
Spokane, WA 99204-2654

Mailing address

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 747-4455

Other identifiers 1

IdentifierTypeStateIssuer
1124177043OtherWANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191108001786 MT Practitioner - Diagnostic Radiology 6406935022 Reassigns benefits to 3 organizations
I20191108002045 WA Practitioner - Diagnostic Radiology 6406935022 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians
Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians
Moses Lake Community Health CenterGroup PAC ID 1254235138, 76 clinicians
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians
Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians

Practice addresses (Care Compare)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (509) 363-7788

1450 1St Ave SW
Quincy, WA 98848-1695
Phone (509) 787-6423

2360 Mullan Rd
Suite C
Missoula, MT 59808-1811
Phone (509) 363-7788

2419 Mullan Rd
Suite D
Missoula, MT 59808-1856
Phone (509) 363-7788

525 S Cowley St
Spokane, WA 99202-1381
Phone (509) 747-4455

605 S Coolidge St
Suite 101
Moses Lake, WA 98837-1893
Phone (509) 765-0674

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 363-7745

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
  • Northern Montana Hospital Hospital, Havre, MT, CCN 271348
  • Samaritan Hospital Hospital, Moses Lake, WA, CCN 500033
  • Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60995156WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Inland Imaging LLC Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Apr 25, 2022 Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Inland Imaging Associates PS Diagnostic Radiology CurrentSince May 1, 2020 Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Moses Lake Community Health Center CurrentSince Oct 1, 2019 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Okanogan Douglas County Hospital Dist1 CurrentSince Apr 25, 2022 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
Grant County Public Hospital District 3 CurrentSince Dec 4, 2025 Accepting new patients
The Polyclinic CurrentSince Oct 1, 2019 Accepting new patients
Moses Lake Community Health Center CurrentSince Oct 1, 2019 Accepting new patients
The Polyclinic PLLC CurrentSince Oct 1, 2019 Accepting new patients
Grant County Public Hospital District 2 CurrentSince Nov 9, 2019 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Diagnostic Imaging Inc Diagnostic Radiology Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2740 South Ave W
Missoula, MT 59804
Phone (406) 728-6010

2419 Mullan Rd
Ste D
Missoula, MT 59808
Phone (406) 540-1512

2360 Mullan Rd
Ste C
Missoula, MT 59808
Phone (406) 542-9695

500 E Webster Ave
Chewelah, WA 99109
Phone (509) 482-2154

1012 S 3rd St
Dayton, WA 99328
Phone (509) 382-2531

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674

908 10th Ave SW
Quincy, WA 98848
Phone (509) 787-3503

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1145 Broadway
Seattle, WA 98122

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

525 S Cowley St
Spokane, WA 99202
Phone (509) 625-3397

801 S Stevens St
Spokane, WA 99204
Phone (206) 621-4316

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 5

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1124177043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-747-4455",
            "fax_number": "509-363-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-747-4455",
            "fax_number": "509-363-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "STEPHANIE",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60995156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124177043",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.