Individual provider Active NPI

Stefanie Eller

  • Surgical Physician Assistant
  • Wenatchee, WA
National Provider Identifier
1558843201
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
532 Cedar Wood LN
Wenatchee, WA 98801-2476
Phone
(509) 630-9919
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X OR Primary

Addresses

Primary practice location

532 Cedar Wood LN
Wenatchee, WA 98801-2476

Mailing address

532 Cedar Wood LN
Wenatchee, WA 98801-2476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200512002783 OR Practitioner - Physician Assistant 5799116430 Reassigns benefits to 1 organization
I20260320002196 WA Practitioner - Physician Assistant 5799116430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

3209 S 23Rd St
Suite 100
Tacoma, WA 98405-1602
Phone (253) 459-6999

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

665 Winter St SE
Salem, OR 97301-3934
Phone (503) 561-5200

875 Oak St SE
Salem, OR 97301-3975
Phone (503) 561-5200

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Apr 6, 2020 Accepting new patients

Locations

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

875 Oak St SE
Bldg C
Salem, OR 97301
Phone (503) 814-2483

Interoperability endpoints

  • Direct secure messaging: seller286343@direct.salemhealth.org

Organizations & group practices 3

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 3

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1558843201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 CEDAR WOOD LN",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 CEDAR WOOD LN",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012476",
            "telephone_number": "509-630-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "STEFANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.