NPIMap

Individual provider Active NPI

Stephen A Hussey, M.D.

  • Family Medicine Physician
  • Lakeview, OR
National Provider Identifier
1881671576
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD22430 Issued in OR
Practice address
624 S J St
Lakeview, OR 97630-1680
Phone
(541) 947-3366
Fax
(541) 947-4404
NPI assigned
Dec 23, 2005
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD22430 OR Primary

Addresses

Primary practice location

624 S J St
Lakeview, OR 97630-1680

Mailing address

624 S J St
Lakeview, OR 97630-1680
Phone (541) 947-3366

Other identifiers 1

IdentifierTypeStateIssuer
288243MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address 000226@lake.cernerdirect.com Direct

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
I20040405001128 OR Practitioner - Family Practice 9436049426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Health DistrictGroup PAC ID 4284629221, 56 clinicians

Practice addresses (Care Compare)

700 S J St
Lakeview, OR 97630-1623
Phone (541) 947-2114

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22430ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Healthcare Services Texas CurrentSince Feb 21, 2025 Accepting new patients
Northwest Footcare, LLC Past Accepting new patients
Lake Health District Past Accepting new patients
Lake County Medical Clinic, P.C. Family Medicine PastSince Jan 1, 2002 Accepting new patients

Locations

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/91732642-b694-4776-bbd7-c7859cc968c4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1881671576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S J ST",
            "city": "LAKEVIEW",
            "state": "OR",
            "postal_code": "976301680",
            "telephone_number": "541-947-3366",
            "fax_number": "541-947-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S J ST",
            "city": "LAKEVIEW",
            "state": "OR",
            "postal_code": "976301680",
            "telephone_number": "541-947-3366",
            "fax_number": "541-947-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSEY",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD22430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288243",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "000226@lake.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Lake District Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "624 S J St",
            "city": "Lakeview",
            "state": "OR",
            "country_code": "US",
            "postal_code": "976301680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeview, OR

Sources for this page

Verify at the official NPI Registry.