NPIMap

Individual provider Active NPI

Stacey Lee Hiles, M.D.

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1922266162
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60021347 Issued in WA
Practice address
17900 Talbot Rd S
Ste 101
Renton, WA 98055-8212
Phone
(425) 235-9614
Fax
(425) 235-1060
NPI assigned
May 23, 2008
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 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 60021347 WA Primary

Addresses

Primary practice location

17900 Talbot Rd S
Ste 101
Renton, WA 98055-8212

Mailing address

17900 Talbot Rd S
Ste 101
Renton, WA 98055-8212
Phone (425) 235-9614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080923000177 WA Practitioner - Family Practice 8325115033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stacey L Hiles MD PLLCGroup PAC ID 1850468570, 3 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

17900 Talbot Rd S
Renton, WA 98055-8212
Phone (425) 235-9614

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.26 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60021347WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stacey L. Hiles, M.D., PLLC CurrentSince Jul 25, 2008 Accepting new patients

Locations

400 29th St NE
Puyallup, WA 98372
Phone (253) 840-4400

17900 Talbot Rd S
Ste 101
Renton, WA 98055
Phone (425) 235-9614

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1922266162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 TALBOT RD S",
            "address_2": "STE 101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558212",
            "telephone_number": "425-235-9614",
            "fax_number": "425-235-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 TALBOT RD S",
            "address_2": "STE 101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558212",
            "telephone_number": "425-235-9614",
            "fax_number": "425-235-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILES",
        "first_name": "STACEY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60021347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.