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

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

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Shaneen Diane Stacer
Gender	Female
Speciality	Psychologist - Clinical
Location	1900 Woodland Dr, Coos Bay, Oregon
Accepts Medicare Assignments	Medicare 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.

Identifier	Type	State	Issuer
1427485440	NPI	-	NPPES
161133	Other	OR	NORTH BEND MEDICAL CENTER GROUP MEDICAID
R0000WFBTV	Other	OR	NORTH BEND MEDICAL CENTER GROUP MEDICARE
500684206	Medicaid	OR
1407812365	Other	OR	NORTH BEND MEDICAL CENTER GROUP NPI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	3079-57 (Wisconsin)	Secondary
103TA0400X	Psychologist - Addiction (substance Use Disorder)	3079-57 (Wisconsin)	Secondary
103TB0200X	Psychologist - Cognitive & Behavioral	3079-57 (Wisconsin)	Secondary
103TC0700X	Psychologist - Clinical	3079-57 (Wisconsin)	Secondary
103TC2200X	Psychologist - Clinical Child & Adolescent	3079-57 (Wisconsin)	Secondary
103TH0004X	Psychologist - Health	3079-57 (Wisconsin)	Secondary
103TH0100X	Psychologist - Health Service	3079-57 (Wisconsin)	Secondary
103TP2701X	Psychologist - Group Psychotherapy	3079-57 (Wisconsin)	Secondary
103TC0700X	Psychologist - 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 Name	North Bend Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407812365 PECOS PAC ID: 5597677716 Enrollment ID: O20031105000138

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 Address	Practice 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

Reviews and Comments

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

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