Dr Shaneen Diane Stacer, PHD - Medicare Psychologist in Coos Bay, OR

Dr Shaneen Diane Stacer, PHD is a medicare enrolled "Psychologist - Clinical" provider in Coos Bay, Oregon. Her current practice location is 1900 Woodland Dr, Coos Bay, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 267-5151.

Dr Shaneen Diane Stacer is licensed to practice in Oregon (license number 2500) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427485440.

Contact Information

Dr Shaneen Diane Stacer, PHD
1900 Woodland Dr,
Coos Bay, OR 97420-2045
(541) 267-5151
(541) 266-4554



Healthcare Provider's Profile

Full NameDr Shaneen Diane Stacer
GenderFemale
SpecialityPsychologist - Clinical
Location1900 Woodland Dr, Coos Bay, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1427485440
  • Provider Enumeration Date: 10/04/2013
  • Last Update Date: 09/08/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 8628398567
  • Enrollment ID: I20150518001034

Medical Identifiers

Medical identifiers for Dr Shaneen Diane Stacer such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427485440NPI-NPPES
161133OtherORNORTH BEND MEDICAL CENTER GROUP MEDICAID
R0000WFBTVOtherORNORTH BEND MEDICAL CENTER GROUP MEDICARE
500684206MedicaidOR
1407812365OtherORNORTH BEND MEDICAL CENTER GROUP NPI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 3079-57 (Wisconsin)Secondary
103TA0400XPsychologist - Addiction (substance Use Disorder) 3079-57 (Wisconsin)Secondary
103TB0200XPsychologist - Cognitive & Behavioral 3079-57 (Wisconsin)Secondary
103TC0700XPsychologist - Clinical 3079-57 (Wisconsin)Secondary
103TC2200XPsychologist - Clinical Child & Adolescent 3079-57 (Wisconsin)Secondary
103TH0004XPsychologist - Health 3079-57 (Wisconsin)Secondary
103TH0100XPsychologist - Health Service 3079-57 (Wisconsin)Secondary
103TP2701XPsychologist - Group Psychotherapy 3079-57 (Wisconsin)Secondary
103TC0700XPsychologist - Clinical 2500 (Oregon)Primary

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. Dr Shaneen Diane Stacer allows following entities to bill medicare on her behalf.
Entity NameNorth Bend Medical Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407812365
PECOS PAC ID: 5597677716
Enrollment ID: O20031105000138

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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. Dr Shaneen Diane Stacer 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
Dr Shaneen Diane Stacer, PHD
1900 Woodland Dr,
Coos Bay, OR 97420-2045

Ph: (541) 267-5151
Dr Shaneen Diane Stacer, PHD
1900 Woodland Dr,
Coos Bay, OR 97420-2045

Ph: (541) 267-5151

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Halyard Health to develop high-speed machine to manufacture respirators for use during pandemic

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Psychologist in Coos Bay, OR

Dr. Gail Loree Wahl, PH.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 320 Central Ave, Suite 514, Coos Bay, OR 97420
Phone: 541-269-1749    Fax: 541-269-1749
Dr. James Johnston Martin, M.D.
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 2085 Thompson Road, Coos Bay, OR 97420
Phone: 542-269-5333    Fax: 541-269-5609
James M. Wahl,
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 320 Central Ave., Suite 418, Coos Bay, OR 97420
Phone: 541-269-1334    Fax: 541-269-7824
Mr. Samuel Haskin Aley, MS
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 678 14th Ct, Coos Bay, OR 97420
Phone: 541-260-2106    

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