STACEY NOEL BOOMER PA-C
NPI 1790835932
Physician Assistant in Spokane, WA

Q: What is Stacey Boomer's NPI number?

The NPI number for Stacey Boomer is 1790835932. It was assigned to this individual provider in the NPPES registry on January 11, 2007. The provider is also known as Stacey Noel Roberts.

Q: What is Stacey Boomer's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Boomer was last updated on January 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since January 11, 2007PECOS EnrolledAccepts Medicare Assignment

322 W NORTH RIVER DR, SPOKANE, WA 99201(509) 324-6464(509) 241-2056 Get Directions Write a Review

NPPES record last updated: January 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stacey Noel Boomer Pa-c NPPES

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

STACEY NOEL BOOMER PA-C (NPI 1790835932) is an individual physician assistant in Spokane, Washington, licensed in Washington (PA10005143) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Deaconess Medical Center, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1790835932

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSTACEY NOEL BOOMERCredential: PA-C

Location Address322 W NORTH RIVER DRSpokane, WA 99201-3208

Mailing Address322 W North River DrSpokane, WA 99201-3208 · (509) 324-6464 · Fax (509) 241-2056

Phone(509) 324-6464

Fax(509) 241-2056

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJanuary 11, 2007

Last NPPES UpdateJanuary 27, 2022

NPPES CertifiedJanuary 27, 2022

✔ NPI 1790835932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WA · PA10005143

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

322 W NORTH RIVER DR, Spokane, WA 99201

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Other Names 1

Former Name (1)Stacey Noel Roberts

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stacey Noel Boomer Pa-c 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 ID3072615558

PECOS Enrollment IDI20070301000579

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

237 services210 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

34 services33 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

28 services26 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636

This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.

17 services16 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Deaconess Medical Center

Acute Care Hospitals · Spokane, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500044

LocationW 800 Fifth AvenueSpokane, WA 99210 · Spokane County

Emergency services Birthing friendly

Tacoma General Allenmore Hospital

Acute Care Hospitals · Tacoma, WA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500129

Location315 S Mlk Jr WayTacoma, WA 98405 · Pierce County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99201 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

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.

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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.

EDWARD P. BROW M.D.

Family Medicine