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STARK MEDICAL GROUP PC
NPI 1063754208
Nurse Practitioner - Family in Ontario, OR

Active since March 26, 2013CLIA 38D0940524 · Waiver
932 W IDAHO AVE STE 100, ONTARIO, OR 97914(541) 889-2244(541) 889-2626 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 19, 2022, Apr 5, 2022 (2 updates tracked since 2022).

About Stark Medical Group Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STARK MEDICAL GROUP PC (NPI 1063754208) is a healthcare organization registered as a family in Ontario, Oregon and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through December 31, 2027, maintains a secondary practice location in Ontario, and lists Brenda L Stark, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1063754208
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSTARK MEDICAL GROUP PC
Location Address932 W IDAHO AVE STE 100Ontario, OR 97914-2155
Mailing AddressPo Box JOntario, OR 97914-0020 · (541) 889-2244 · Fax (541) 889-2626
Phone(541) 889-2244
Fax(541) 889-2626
Organization SubpartNo
Authorized OfficialBrenda L StarkOffice Manager · (541) 889-2244
Enumeration DateMarch 26, 2013
Last NPPES UpdateJune 22, 20262 updates tracked since enumeration
NPPES CertifiedJune 22, 2026
✔ NPI 1063754208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 079043254N1
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 200550081NP (OR)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
932 W IDAHO AVE STE 100, Ontario, OR 97914
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Secondary Practice Location 1

Location 11219 SW 4th Ave, Suite 2Ontario, OR 97914 · Phone (541) 889-2244

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stark Medical Group Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Stark Medical Group PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Morris Smith, MD
Internal Medicine
NPI 1487611877
932 W IDAHO AVE
Ontario, OR 97914
(541) 889-2244
✔ PECOS✔ Accepts MedicareSame address
Jody Stark, NP
Nurse Practitioner
NPI 1851472989
932 W IDAHO AVE SUITE 100
Ontario, OR 97914
(541) 889-2244
✔ PECOS✔ Accepts MedicareSame address
Sarah Chandler, DNP
Nurse Practitioner
NPI 1720144793
932 W IDAHO AVE STE 100
Ontario, OR 97914
(541) 889-2244
✔ PECOS✔ Accepts MedicareSame address
Rieneke White, FNP-BC, CNM
Certified Nurse Midwife (CNM)
NPI 1851649933
1052 SW 4TH AVE STE 2
Ontario, OR 97914
(541) 709-5338
✔ PECOS✔ Accepts Medicare0.3 mi
Mary Stark, RN, MS, FNP, DNP
Nurse Practitioner
NPI 1871629055
3579 FRANKLIN BLVD
Eugene, OR 97403
(541) 344-9411
✔ PECOS✔ Accepts Medicare302 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D0940524

Stark Medical Group PC · Ontario, OR
Active · expires Dec 31, 2027
CLIA Number38D0940524
Laboratory TypePhysician Office
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorJody A. Stark
Laboratory Phone(541) 889-2244
Laboratory LocationStark Medical Group PC1219 SW 4th Ave Ste 2, Ontario, OR 97914
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stark Medical Group PC's NPI number?

The NPI number for Stark Medical Group PC is 1063754208. It was assigned to this organization in the NPPES registry on March 26, 2013.

Where is Stark Medical Group PC located?

Stark Medical Group PC is located at 932 W Idaho Ave Ste 100, Ontario, OR 97914. The listed phone number is (541) 889-2244.

What is Stark Medical Group PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Stark Medical Group PC enrolled in Medicare?

Yes. Stark Medical Group PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stark Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Stark Medical Group PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Certified Nurse Midwife (CNM) (1) and Internal Medicine (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Stark Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0940524) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Stark Medical Group PC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Molina Healthcare and Regence BlueCross BlueShield of Oregon list Stark Medical Group PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stark Medical Group PC was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.