Individual provider Active NPI

Stacey S Donlan, MD

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1740358290
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00032729 Issued in WA
Practice address
2950 Northup Way Ste 210
Bellevue, WA 98004-1406
Phone
(425) 284-3377
Fax
(425) 827-1040
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00032729 WA Primary

Addresses

Primary practice location

2950 Northup Way Ste 210
Bellevue, WA 98004-1406

Mailing address

2950 Northup Way Ste 210
Bellevue, WA 98004-1406
Phone (425) 284-3377

Other identifiers 1

IdentifierTypeStateIssuer
2950DOOtherWAREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000536 WA Practitioner - Internal Medicine 0042111221 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00032729WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Discover Health Medical Group 2, Inc. Internal Medicine CurrentSince Jul 22, 2023 Accepting new patients
Overlake Internal Medicine Associates Inc PS Internal Medicine Past Accepting new patients

Locations

2950 Northup Way
Ste 210
Bellevue, WA 98004
Phone (425) 284-3377

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10147/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1740358290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 NORTHUP WAY STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041406",
            "telephone_number": "425-284-3377",
            "fax_number": "425-827-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 NORTHUP WAY STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041406",
            "telephone_number": "425-284-3377",
            "fax_number": "425-827-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONLAN",
        "first_name": "STACEY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00032729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2950DO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.