Stephanie Rose Moline, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

MD00041718 Issued in WA

Practice address

700 W Ironwood Dr Ste 130
Coeur D Alene, ID 83814-4404

Phone

(208) 625-4700

Fax

(208) 625-4701

NPI assigned

Oct 19, 2005

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 8

Other names 1

• Stephanie Rose Perry Former name

Medicare fee-for-service enrollment

Enrolled in WA, ID2 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

Specialty

Surgical Oncology

Education

Vanderbilt University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer Care Northwest Centers P SGroup PAC ID 4688561939, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331
• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoline350964@direct.multicare.org

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.

• Cancer Care Northwest Centers P S

  • Hematology & Oncology Physician
  • Spokane Valley, WA
  • NPI 1922072081

  Surgical Oncology

  Medicare reassignment Care Compare group NPD
• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur D Alene, ID
  • NPI 1174661151
  Medicare reassignment NPD
• Kootenai Health, Inc.

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD
• Kootenai Health, Inc.

  • Hematology & Oncology Physician
  • Coeur D Alene, ID
  • NPI 1699807743
  NPD
• Cancer Care Northwest Centers P S

  • Non-Pharmacy Dispensing Site
  • Spokane, WA
  • NPI 1144900705
  NPD
• Columbia Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Spokane, WA
  • NPI 1710696372
  NPD (past)
• Spartanburg Hospital for Restorative Care

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1649293580
  NPD (past)

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation
• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1225027436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203868",
            "telephone_number": "509-228-1000",
            "fax_number": "509-252-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 130",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144404",
            "telephone_number": "208-625-4700",
            "fax_number": "208-625-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Sherman St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992021311",
            "country_code": "US",
            "telephone_number": "509-228-1000",
            "fax_number": "509-252-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLINE",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "ID",
            "license": "7761579",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "WA",
            "license": "MD00041718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "910000395",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8322315",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0164026",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7744005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806453700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "7631MO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010140846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "KS665",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "PERRY",
            "middle_name": "ROSE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mamie Nora Mitchell, LMSW
• Sarah Mitchell, RN
• Lucy Elizabeth Modahl, MD, PHD
• Michael Mohr, PA
• Stephanie Mokry, B.S. CADC
• Monarch Counseling Services
• Monarch Mental Health
• Monarch Mental Health, LLC
• Richard John Montandon, D.D.S.
• Shari Vandyke Montandon, D.O.

• Surgical Oncology Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Surgical Oncology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.