NPIMap

Individual provider Active NPI

Christopher Stamatakos, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1326068792
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003798 Issued in WA
Practice address
2101 NE 139TH St Ste 450
Vancouver, WA 98686-2325
Phone
(360) 487-4848
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003798 WA Primary

Addresses

Primary practice location

2101 NE 139TH St Ste 450
Vancouver, WA 98686-2325

Mailing address

2101 NE 139TH St Ste 450
Vancouver, WA 98686-2325
Phone (360) 487-4848

Other identifiers 1

IdentifierTypeStateIssuer
8320871MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051013000023 WA Practitioner - Physician Assistant 7618992124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

1919 NW Lovejoy St
Portland, OR 97209-1503

2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2325
Phone (360) 487-2727

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003798WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Nov 12, 2018 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Nov 12, 2018 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 1, 2008 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 1, 2008 Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

16811 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 514-4900

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 450
Vancouver, WA 98686
Phone (360) 487-4848

2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727

Interoperability endpoints

  • Direct secure messaging: cstamatakos4150@direct.lhs.org

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 8

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1326068792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST STE 450",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862325",
            "telephone_number": "360-487-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST STE 450",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862325",
            "telephone_number": "360-487-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMATAKOS",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8320871",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.