Individual provider Active NPI

Stacy Butler, M.D.

  • Obstetrics & Gynecology Physician
  • Loma Linda, CA
National Provider Identifier
1659799385
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C206164 Issued in CA
Practice address
11370 Anderson St
Loma Linda, CA 92354-3450
Phone
(909) 558-2806
Fax
(909) 558-2450
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C206164 CA Primary
Obstetrics & Gynecology Physician 207V00000X MD187004 OR

Addresses

Primary practice location

11370 Anderson St
Loma Linda, CA 92354-3450

Mailing address

11175 Campus St
CP-11105
Loma Linda, CA 92350-1700
Phone (909) 651-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 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
I20180827003281 OR Practitioner - Obstetrics/Gynecology 7113223074 Reassigns benefits to 2 organizations
I20260313002011 CA Practitioner - Obstetrics/Gynecology 7113223074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians
Sac Health SystemGroup PAC ID 4385533579, 222 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

2195 Club Ctr Dr
San Bernardino, CA 92408-4162
Phone (909) 835-1750

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

488 S K St
San Bernardino, CA 92410-2641
Phone (909) 383-8092

Hospital & facility affiliations

  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C206164CAMDObstetrics & Gynecology Physician
MD187004ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Obstetrics & Gynecology Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 1, 2026 Accepting new patients
Providence Health & Services Oregon Obstetrics & Gynecology Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 1, 2026 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

11370 Anderson St
Loma Linda, CA 92354
Phone (909) 558-2481

12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

10330 SE 32nd Ave
Ste 305
Milwaukie, OR 97222
Phone (503) 408-4078

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

545 NE 47th Ave
Ste 102
Portland, OR 97213
Phone (503) 215-6262

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: sbutler1147590@oc.providencedirect.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1659799385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST",
            "address_2": "CP-11105",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-651-5951",
            "fax_number": "909-651-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2806",
            "fax_number": "909-558-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "STACY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C206164",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD187004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.