Individual provider Active NPI

Sean Stuart Stout, M.D.

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1316925498
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042359 Issued in WA
Practice address
3908 10TH St SE
Puyallup, WA 98374-2188
Phone
(253) 848-5951
Fax
(253) 845-7073
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00042359 WA Primary

Addresses

Primary practice location

3908 10TH St SE
Puyallup, WA 98374-2188

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000745 WA Practitioner - Family Practice 3577691740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Hill Family Medicine PCGroup PAC ID 8729980396, 67 clinicians

Practice addresses (Care Compare)

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Hospital & facility affiliations

  • Puget Sound Home Health Home health agency, Tacoma, WA, CCN 507101
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042359WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Hill Family Medicine PC Family Medicine CurrentSince Nov 1, 2003 Accepting new patients

Locations

10004 204th Ave E
Ste 3400
Bonney Lake, WA 98391
Phone (253) 841-9640

3909 10th St SE
Puyallup, WA 98374
Phone (253) 286-4132

611 31st Ave SW
Ste C
Puyallup, WA 98373
Phone (253) 848-5951

3908 10th St SE
Puyallup, WA 98374
Phone (253) 848-5951

Interoperability endpoints

  • Direct secure messaging: sstout35062@direct.tecmc.com

Organizations & group practices 1

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 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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1316925498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "SEAN",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.