Active NPI
David E Stage, MD
- Rheumatology Physician
- Lynnwood, WA
National Provider Identifier
1235280512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD00010713
- Practice address
- 19116 33Rd Ave W
Lynnwood, WA 98036-4706 - Phone
- (425) 771-7500
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | MD00010713 | WA | Primary |
Addresses
Primary practice location
19116 33Rd Ave W
Lynnwood, WA 98036-4706
Mailing address
1100 Olive Way MSC M4-PA
Seattle, WA 98101-1873
Phone (206) 515-5811
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD594WA | Medicaid | AK | |
| US0818870 | Other | WA | AETNA PCP PIN |
| S696 | Other | WA | BLUE SHIELD # |
| US0899988 | Other | WA | AETNA SPECIALIST PIN |
| 40007216 | Other | WA | RAILROAD MC# |
| 8268609 | Medicaid | WA | |
| 0039583 | Other | WA | LABOR AND INDUSTRIES # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00010713 | WA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1235280512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 OLIVE WAY MSC M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011873",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19116 33RD AVE W",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364706",
"telephone_number": "425-771-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAGE",
"first_name": "DAVID",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "WA",
"license": "MD00010713",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD594WA",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PCP PIN",
"identifier": "US0818870",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD #",
"identifier": "S696",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPECIALIST PIN",
"identifier": "US0899988",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MC#",
"identifier": "40007216",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8268609",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES #",
"identifier": "0039583",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.