NPIMap

Individual provider Active NPI

Stephany Hassen, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1174916449
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006220 Issued in CO
Practice address
904 7TH Ave
Floor 3
Seattle, WA 98104-1132
Phone
(206) 860-4541
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA60539314 WA
Physician Assistant 363A00000X PA.0006220 CO Primary

Addresses

Primary practice location

904 7TH Ave
Floor 3
Seattle, WA 98104-1132

Mailing address

1082 Fairview Ave
Apartment R3
Bowling Green, OH 43402-1257
Phone (567) 686-7930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150624000097 WA Practitioner - Physician Assistant 7810208402 Reassigns benefits to 1 organization
I20221101002360 CO Practitioner - Physician Assistant 7810208402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6705 Rangewood Dr
Colorado Springs, CO 80918-7300
Phone (719) 599-7331

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0006220COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Nov 28, 2022 Accepting new patients
The Polyclinic PLLC CurrentSince Jun 1, 2015 Accepting new patients
The Polyclinic PLLC CurrentSince Jun 1, 2015 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Nov 28, 2022 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

6705 Rangewood Dr
Colorado Springs, CO 80918
Phone (719) 364-0900

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1145 Broadway
Seattle, WA 98122

904 7th Ave
Fl 3
Seattle, WA 98104
Phone (206) 292-2249

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1174916449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1082 FAIRVIEW AVE",
            "address_2": "APARTMENT R3",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434021257",
            "telephone_number": "567-686-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "address_2": "FLOOR 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-860-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSEN",
        "first_name": "STEPHANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60539314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.