NPIMap

Individual provider Active NPI

Stephanie C Mittelstaedt, MD, MPH

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1336406107
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60671178 Issued in WA
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 882-2778
Fax
(360) 604-1767
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD167984 OR
Internal Medicine Physician 207R00000X MD60671178 WA Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

PO Box 873010
Vancouver, WA 98687-3010
Phone (360) 882-2778

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
I20161104001620 WA Practitioner - Internal Medicine 1254565401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital District No. 2, Klickitat County, WashingtonGroup PAC ID 4981592144, shared by 4 NPIs, 40 clinicians
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

211 NE Skyline Dr
White Salmon, WA 98672-1948
Phone (509) 493-1101

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD167984ORMDInternal Medicine Physician
MD60671178WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 2, Klickitat County Washington CurrentSince May 1, 2023 Accepting new patients
The Vancouver Clinic Inc PS Internal Medicine CurrentSince Oct 17, 2016 Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince May 1, 2023 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington CurrentSince Dec 1, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 17, 2016 Accepting new patients
Peacehealth Past Accepting new patients

Locations

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

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

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

Organizations & group practices 6

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 6

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1336406107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873010",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986873010",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELSTAEDT",
        "first_name": "STEPHANIE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD167984",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60671178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.