Individual provider Active NPI

Frank A Stackhouse, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1164551255
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00031288 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2499
Phone
(206) 744-3000
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00031288 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2499

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
8155277MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR, MI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210127002190 TX Practitioner - Internal Medicine 7911023247 Reassigns benefits to 1 organization
I20220401001011 OR Practitioner - Internal Medicine 7911023247 Reassigns benefits to 1 organization
I20241210000249 MI Practitioner - Internal Medicine 7911023247 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sault Tribe of Chippewa Indians CurrentSince Oct 1, 2024 Accepting new patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Apr 1, 2022 Accepting new patients
Mid-Columbia Medical Center Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Mid-Columbia Medical Center Current Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Dec 20, 2020 Accepting new patients
Sault Tribe of Chippewa Indians CurrentSince Oct 1, 2024 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Dec 20, 2020 Accepting new patients

Locations

2864 Ashmun St
Sault South Marie, MI 49783
Phone (906) 632-5200

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

Organizations & group practices 12

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1164551255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042499",
            "telephone_number": "206-744-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKHOUSE",
        "first_name": "FRANK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00031288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8155277",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.