Individual provider Active NPI

Brian E Staley, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Spokane, WA
National Provider Identifier
1659351344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
3480671205 Issued in UT
Practice address
13103 E Mansfield
Incyte Pathology PS
Spokane, WA 99216
Phone
(509) 892-2700
Fax
(509) 892-2740
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 3480671205 UT Primary

Addresses

Primary practice location

13103 E Mansfield
Incyte Pathology PS
Spokane, WA 99216

Mailing address

PO Box 3405
Incyte Pathology, PS
Spokane, WA 99220-3405
Phone (509) 892-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060605000180 WA Practitioner - Pathology 0042124067 Reassigns benefits to 1 organization
I20250311002437 OR Practitioner - Pathology 0042124067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Utah School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 677-2452

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Merit-based Incentive Payment System (MIPS)

Final score
73.29 of 100Reported as group
Quality
68.58
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3480671205UTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group Inc. CurrentSince May 1, 2025 Accepting new patients

Locations

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

201 NW Medical Loop
Ste 190
Roseburg, OR 97471
Phone (541) 644-4319

Organizations & group practices 2

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 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659351344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3405",
            "address_2": "INCYTE PATHOLOGY, PS",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203405",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13103 E MANSFIELD",
            "address_2": "INCYTE PATHOLOGY PS",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99216",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "3480671205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.