Stacy Diane Ostler, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

M-9953 Issued in ID

Practice address

875 E Plaza Dr Ste 103
Eagle, ID 83616-6549

Phone

(208) 229-7075

NPI assigned

Feb 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Stacy Diane Shoemaker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Spinecare Medical Group Inc

  • Orthopaedic Surgery of the Spine Physician
  • Daly City, CA
  • NPI 1720050859

  Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1649242025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 434",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836160434",
            "telephone_number": "208-229-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E PLAZA DR STE 103",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166549",
            "telephone_number": "208-229-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTLER",
        "first_name": "STACY",
        "middle_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A68685",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "M-9953",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00049170",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAL LICENSE",
            "identifier": "M-9953",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "SHOEMAKER",
            "middle_name": "DIANE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crystal Noel Odegard, PA-C
• Patricia Oleary, PTA
• Onyx Health & Med
• Optimal Healthcare PLLC
• Megan Irene Osborne, PH.D, LPC
• OT 4 Kidz, Inc
• OT 4 Kidz, Inc
• Eric Overton
• Susan Marguerite Owen
• Randi Owsley, MSW

• Physical Medicine & Rehabilitation Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Physical Medicine & Rehabilitation Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.