Active NPI
Christopher J Stacey, P.A.-C
- Medical Physician Assistant
- Bellingham, WA
National Provider Identifier
1407959463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10004130
- Practice address
- 2940 Squalicum Pkwy
#203
Bellingham, WA 98225-1892 - Phone
- (360) 733-0640
- Fax
- (360) 733-1034
- NPI assigned
- Sep 6, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10004130 | WA | Primary |
Addresses
Primary practice location
2940 Squalicum Pkwy
#203
Bellingham, WA 98225-1892
Mailing address
2940 Squalicum Pkwy Ste 203
Bellingham, WA 98225-1892
Phone (360) 738-3223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8353880 | Medicaid | WA |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2940 Squalicum Pkwy
Suite 203
Bellingham, WA 98225-1892
Phone (360) 733-0640
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.31 of 100
- Quality
- 80.61
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10004130 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current | Accepting new patients |
Locations
2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400
3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186
Interoperability endpoints
- cstacey2475141@wm.providencedirect.org
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1407959463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 SQUALICUM PKWY STE 203",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251892",
"telephone_number": "360-738-3223",
"fax_number": "360-733-1034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 SQUALICUM PKWY",
"address_2": "#203",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251892",
"telephone_number": "360-733-0640",
"fax_number": "360-733-1034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACEY",
"first_name": "CHRISTOPHER",
"middle_name": "J",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10004130",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8353880",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.