NPIMap

Individual provider Active NPI

Stacy L Braff, MD

  • Internal Medicine Physician
  • Richmond, IN
National Provider Identifier
1780607606
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD205244 Issued in OR
Practice address
1605 Chester Blvd
Richmond, IN 47374-1610
Phone
(765) 373-8253
Fax
(765) 488-0656
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01066923A IN
Internal Medicine Physician 207R00000X MD205244 OR Primary

Addresses

Primary practice location

1605 Chester Blvd
Richmond, IN 47374-1610

Mailing address

1605 Chester Blvd
Richmond, IN 47374-1610
Phone (765) 373-8253

Other practice location 1

3521 NW Samaritan Dr Ste 201
Corvallis, OR 97330-4744
Phone (541) 768-5140

Other names 1

  • Stacy Lynn Pearson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbraff206829@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805003558 OR Practitioner - Internal Medicine 6507763364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD205244ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince Aug 1, 2021 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Good Samaritan Hospital Corvallis Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3521 NW Samaritan Dr
Ste 201
Corvallis, OR 97330
Phone (541) 768-5140

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

Interoperability endpoints

  • Direct secure messaging: sbraff206829@samhealth.direct-ci.com

Organizations & group practices 10

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 66

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 66

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Hospital Corvallis 372 clinicians

Practice addresses (Care Compare)

3517 NW Samaritan Dr
Corvallis, OR 97330-3768

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

3615 NW Samaritan Dr
Corvallis, OR 97330-3771

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1780607606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741610",
            "telephone_number": "765-373-8253",
            "fax_number": "765-488-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741610",
            "telephone_number": "765-373-8253",
            "fax_number": "765-488-0656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3521 NW Samaritan Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973304744",
            "country_code": "US",
            "telephone_number": "541-768-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAFF",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01066923A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD205244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbraff206829@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3521 NW Samaritan Dr Ste 201",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973304744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "PEARSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.