Stephanie Morbeck Persondek, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OP60541488 Issued in WA

Practice address

23403 E Mission Ave Ste 231
Liberty Lake, WA 99019-5087

Phone

(509) 367-4209

Fax

(509) 492-5624

NPI assigned

Jun 22, 2010

Reactivated

Dec 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Stephanie Ann Morbeck Former name

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

Specialty

Obstetrics/Gynecology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Inclusa Health and Wellness PLLCGroup PAC ID 9436540366, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Inclusa Health and Wellness PLLC

  • Obesity Medicine (Obstetrics & Gynecology) Physician
  • Liberty Lake, WA
  • NPI 1891464905
  Medicare reassignment Care Compare group Authorized official
• Seattle Nuclear Medicine-Ultrasound Associates

  • Radiology Clinic/Center
  • Seattle, WA
  • NPI 1265506349
  NPD (past)

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1518288745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23403 E MISSION AVE STE 231",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23403 E MISSION AVE STE 231",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195087",
            "telephone_number": "509-367-4209",
            "fax_number": "509-492-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONDEK",
        "first_name": "STEPHANIE",
        "middle_name": "MORBECK",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "deactivation_date": "2022-12-08",
        "reactivation_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "DO2372",
            "primary": false
        },
        {
            "code": "207VB0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obesity Medicine",
            "state": "WA",
            "license": "OP60541488",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "OP60541488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MORBECK",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel J Osborne, DC
• Rebecca L Pagotelis, PT
• Debbie D Panther, PT
• Paul a Ramos (Health Zone Chiropractic)
• Joseph L Paventy, DMD
• Geraldine Anne Peterdy, MD
• Noland Peterdy, PHARMD, JD, MBA
• Patrick C Peterson, PA-C
• Tyler Peterson Peterson
• Jacklyn Rose Petretee

• Obstetrics & Gynecology Physician in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Obstetrics & Gynecology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.