Individual provider Active NPI

Stefan McNamara

  • Physician Assistant
  • Chehalis, WA
National Provider Identifier
1962020925
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1299 Bishop Rd
Chehalis, WA 98532-8758
Phone
(360) 748-0211
NPI assigned
Jul 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X WA Primary

Addresses

Primary practice location

1299 Bishop Rd
Chehalis, WA 98532-8758

Mailing address

1299 Bishop Rd
Chehalis, WA 98532-8758
Phone (360) 748-0211

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117003048 WA Practitioner - Physician Assistant 7618345943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
L G Steck Memorial Clinic P SGroup PAC ID 7012825342, 4 clinicians
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

1299 Bishop Rd
Chehalis, WA 98532-8758
Phone (360) 748-0211

1720 Cooks Hill Rd
Centralia, WA 98531-9071
Phone (360) 827-8100

525 Lilly Rd NE
Olympia, WA 98506-5101

914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803

Hospital & facility affiliations

  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: smcnamara3197633@wm.providencedirect.org

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.

Hospital & facility affiliations 1

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1962020925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 BISHOP RD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328758",
            "telephone_number": "360-748-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 BISHOP RD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328758",
            "telephone_number": "360-748-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAMARA",
        "first_name": "STEFAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.