Staci M Hestdalen, MD - Medicare Dermatology in Spokane Valley, WA

Staci M Hestdalen, MD is a medicare enrolled "Dermatology" physician in Spokane Valley, Washington. She went to Baylor College Of Medicine and graduated in 1998 and has 26 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Mountain West Derm - Blackhart Pllc, Mountain West Derm - Blackhart Pllc and her current practice location is 1807 N Hutchinson Rd, Spokane Valley, Washington. You can reach out to her office (for appointments etc.) via phone at (509) 456-7414.

Staci M Hestdalen is licensed to practice in Washington (license number MD00043715) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1194790006.

Contact Information

Staci M Hestdalen, MD
1807 N Hutchinson Rd,
Spokane Valley, WA 99212-2444
(509) 456-7414
(509) 624-0763



Physician's Profile

Full NameStaci M Hestdalen
GenderFemale
SpecialityDermatology
Experience26 Years
Location1807 N Hutchinson Rd, Spokane Valley, Washington
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Staci M Hestdalen attended and graduated from Baylor College Of Medicine in 1998
  NPI Data:
  • NPI Number: 1194790006
  • Provider Enumeration Date: 02/22/2006
  • Last Update Date: 08/13/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1254316078
  • Enrollment ID: I20040623001603

Medical Identifiers

Medical identifiers for Staci M Hestdalen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194790006NPI-NPPES
8394454MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology MD00043715 (Washington)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mountain West Derm - Blackhart Pllc1153609813103
Mountain West Derm - Blackhart Pllc1153609813103

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Staci M Hestdalen allows following entities to bill medicare on her behalf.
Entity NameMountain West Derm - Blackhart Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013557933
PECOS PAC ID: 1153609813
Enrollment ID: O20200904001722

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Staci M Hestdalen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Staci M Hestdalen, MD
1807 N Hutchinson Rd,
Spokane Valley, WA 99212-2444

Ph: (509) 456-7414
Staci M Hestdalen, MD
1807 N Hutchinson Rd,
Spokane Valley, WA 99212-2444

Ph: (509) 456-7414

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Dermatology Doctors in Spokane Valley, WA

Joel K Sears, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763
Andrea Mead Dominey, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763
Paul T Dunn, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763
Dr. Robin Louise Hornung, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763
Chadd Sukut, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763
Joseph L Cvancara, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1807 N Hutchinson Rd, Spokane Valley, WA 99212
Phone: 509-456-7414    Fax: 509-624-0763

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