Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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: August 09, 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
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

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

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 PC932 W Idaho Ave Suite 100, 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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
932 W IDAHO AVE STE 100
ONTARIO, OR 97914
Clinical Nurse Specialist (Family Health)
932 W IDAHO AVE STE 100
ONTARIO, OR 97914
Nurse Practitioner (Gerontology)
932 W IDAHO AVE STE 100
ONTARIO, OR 97914
Nurse Practitioner (Adult Health)
932 W IDAHO AVE STE 100
ONTARIO, OR 97914

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.

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. 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 51 days 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.