Stacey Lynn Warren, MSPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60118131 Issued in WA

Practice address

1730 Minor Ave Ste 1000
Seattle, WA 98101-1464

Phone

(206) 267-2100

Fax

(206) 267-2100

NPI assigned

Oct 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swarren@frontierdermpartners.emadirect.md

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.

• Silver Falls Dermatology, LLC

  • Dermatology Physician
  • Salem, OR
  • NPI 1134375421

  Physician Assistant, WA

  Medicare reassignment Care Compare group NPD
• Victor R. Michalak

  • Ambulatory Surgical Clinic/Center
  • Issaquah, WA
  • NPI 1104877976
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1346575206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 320TH ST",
            "address_2": "STE A",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034691",
            "telephone_number": "866-599-3376",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 MINOR AVE STE 1000",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011464",
            "telephone_number": "206-267-2100",
            "fax_number": "206-267-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60118131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808500600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Warren, PH.D.
• Katherine Elida Warren
• Lindsay Warren, PA-C
• Rhonda Ann Warren, PA-C
• Samuel Kendall Warren, MD
• Stephen Warren
• Traci Warren
• Michelle Warsing, MA, LMFTA
• Alice Warsinske, CCC-SLP
• Daniel Wartenberg, PSYD

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.