Palouse Medical PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PALOUSE MEDICAL PS

Practice address

825 SE Bishop Blvd Ste 200
Pullman, WA 99163-5537

Phone

(509) 332-2517

Fax

(509) 334-9247

NPI assigned

Jul 1, 2006

Last updated

Aug 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie M Fosback, MDNPI 1760591622

Title

President

Phone

(509) 332-2517

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Pullman ReadyCare Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie M Fosback, MD

  • Internal Medicine Physician
  • Pullman, WA
  • NPI 1760591622
  Medicare reassignment NPD Authorized official
• Joseph O Aiyenowo, MD

  • Internal Medicine Physician
  • Pullman, WA
  • NPI 1598792657

  Family Medicine

  Medicare reassignment NPD
• Clara E Garcia, MD

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1902433873
  Medicare reassignment NPD
• Nancy Gregory, A.R.N.P.

  • Nurse Practitioner
  • Pullman, WA
  • NPI 1801954003
  Medicare reassignment NPD
• Stephen P Hall, M.D.

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1740211184
  Medicare reassignment NPD
• Justin Scott Lytle, DO

  • Emergency Medical Services (Emergency Medicine) Physician
  • Spokane, WA
  • NPI 1235636853

  Family Medicine

  Medicare reassignment NPD
• Leslie J Robison, PH.D.

  • Health Service Psychologist
  • Pullman, WA
  • NPI 1861584328
  Medicare reassignment NPD
• Kassandra M. Tricola, M.D.

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1922411834
  Medicare reassignment NPD
• Richard K Howe, MD

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1871566679

  WA

  Medicare reassignment NPD
• Christopher J Iacobelli, MD

  • Family Medicine Physician
  • Lewiston, ID
  • NPI 1649295866

  WA

  Medicare reassignment NPD
• Benno J Mohr, MD

  • Internal Medicine Physician
  • Pullman, WA
  • NPI 1275515058
  Medicare reassignment
• Dennis L Simpson, M.D.

  • Internal Medicine Physician
  • Pullman, WA
  • NPI 1316979644
  NPD

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1548299696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 200",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635537",
            "telephone_number": "509-332-2517",
            "fax_number": "509-334-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 200",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635537",
            "telephone_number": "509-332-2517",
            "fax_number": "509-334-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOUSE MEDICAL PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "FOSBACK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-332-2517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7085418",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pullman ReadyCare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pullman ReadyCare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Osborne, ATC, LMP
• Michael Joseph Osterholt, MD
• Carol A Owings, RN
• Palouse ENT, LLC
• Palouse Foot & Ankle Clinic PS
• Palouse Pediatrics, PLLC
• Palouse Psychiatry and Behavioral Health
• Palouse Recovery Center LLC (PRC)
• Palouse Ridge Counseling
• Palouse River Counseling Center (Palouse River Counseling)

• Family Medicine Physician in Pullman, WA
• Providers in Pullman, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.