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STACY BUTLER M.D.
NPI 1659799385
Obstetrics & Gynecology in Loma Linda, CA

Active since March 31, 2014PECOS EnrolledAccepts Medicare Assignment
87.76/100
CMS Quality Rating
11370 ANDERSON ST, LOMA LINDA, CA 92354(909) 558-2806(909) 558-2450 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 14, 2026, Feb 15, 2021, Dec 13, 2019 (3 updates tracked since 2019).

About Stacy Butler M.d. NPPES

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

STACY BUTLER M.D. (NPI 1659799385) is an individual obstetrics & gynecology provider in Loma Linda, California, licensed in California (C206164) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Loma Linda University School Of Medicine (2014).

NPPES Registry Identity

NPI1659799385
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameSTACY BUTLERCredential: M.D.
Location Address11370 ANDERSON STLoma Linda, CA 92354-3450
Mailing Address11175 Campus St, Cp-11105Loma Linda, CA 92350-1700 · (909) 651-5951 · Fax (909) 651-5401
Phone(909) 558-2806
Fax(909) 558-2450
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2014
Enumeration DateMarch 31, 2014
Last NPPES UpdateApril 14, 20263 updates tracked since enumeration
NPPES CertifiedApril 14, 2026
✔ NPI 1659799385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in CA · C206164✔ Licensed in OR · MD187004
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
11370 ANDERSON ST, Loma Linda, CA 92354
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stacy Butler M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113223074
PECOS Enrollment IDI20260313002011
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Stacy Butler reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm
Same address
Obstetrics & Gynecology
11370 ANDERSON STREET, SUITE 3900
Loma Linda, CA 92354
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1235189275 (909) 558-2806
Sac Health System
3.9 mi
Federally Qualified Health Center (FQHC)
1454 E 2ND ST
San Bernardino, CA 92408
  • Reassigned Medicare billing, California enrollment
  • 455 clinicians in this Medicare group
NPI 1013935915 (909) 382-7100
Providence Health & Services Oregon
836 mi
General Acute Care Hospital
10150 SE 32ND AVE
Milwaukie, OR 97222
  • Reassigned Medicare billing, Oregon enrollment
  • 229 clinicians in this Medicare group
NPI 1366536963 (503) 451-3000
Providence Health & Services - Oregon
841 mi
General Acute Care Hospital
4805 NE GLISAN ST
Portland, OR 97213
  • Reassigned Medicare billing, Oregon enrollment
  • 676 clinicians in this Medicare group
NPI 1003991845 (503) 451-3000

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence St Vincent Medical Center

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380004
Location9205 SW Barnes RoadPortland, OR 97225 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.17
Promoting Interoperability100
Improvement Activities40
Cost74.03

Other Providers at the Same Location NPPES 20

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

JESSICA VILLAFRANCO
Social Worker (Clinical)
11370 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-5978
JOHN Y KIM M.D.
Otolaryngology
11370 ANDERSON ST, SUITE 2100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2822
EDMUND YUEY KUN KO M.D.
Urology
11370 ANDERSON ST, SUITE 1100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2830
SNORRI OLAFSSON M.D.
Internal Medicine (Gastroenterology)
11370 ANDERSON ST, STE 3150
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2191
SIGVE K. TONSTAD M.D.
Internal Medicine
11370 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2870
KHASHAYAR DASHTIPOUR M.D.
Psychiatry & Neurology (Neurology)
11370 ANDERSON ST, SUITE 2400
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2880
DOUGLAS DEMING M.D.
Pediatrics (Neonatal-Perinatal Medicine)
11370 ANDERSON ST, STE B-100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2848
ABEL TORRES M.D.
Dermatology (MOHS-Micrographic Surgery)
11370 ANDERSON ST, STE 2600
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2055

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 Stacy Butler's NPI number?

The NPI number for Stacy Butler is 1659799385. It was assigned to this individual provider in the NPPES registry on March 31, 2014.

Where is Stacy Butler located?

Stacy Butler practices at 11370 Anderson St, Loma Linda, CA 92354. The listed phone number is (909) 558-2806.

What is Stacy Butler's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Stacy Butler enrolled in Medicare?

Yes. Stacy Butler is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Stacy Butler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Butler reassigns Medicare benefits to 4 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA), Sac Health System (San Bernardino, CA), Providence Health & Services Oregon (Milwaukie, OR) and Providence Health & Services - Oregon (Portland, OR). Each 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 Stacy Butler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Stacy Butler affiliated with any hospitals?

According to CMS data, Stacy Butler is affiliated with Providence St Vincent Medical Center.

When was this NPI record last updated?

The NPPES record for Stacy Butler was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.