STACY LEILANI WHITAKER (DO) – Obstetrics & Gynecology Physician, NPI 1316064512

STACY LEILANI WHITAKER (DO) is a healthcare provider. based in La grande, Oregon. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials DO. They hold a License No. 11323 (MT). The NPI Number for STACY LEILANI WHITAKER (DO) is 1316064512

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
STACY LEILANI WHITAKER (DO)
NPI
1316064512
Phone
(541) 963-1883
Address
PO BOX 3290
Enumeration Date
23 March 2007
Last Update Date
22 January 2010

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
1355446055
Group Practice PAC ID
0547170789
Professional Enrollment ID
I20100317000553
Address ID
OR978507290LAPOXXXBOXX202
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

632 OBSTETRICS/GYNECOLOGY in OR

Provider Addresses for STACY LEILANI WHITAKER (DO)

  • PO BOX 3290

    LA GRANDE, OR 978507290

    Phone: (541) 963-1883

    Fax: (541) 963-1837

    Type: Mailing

  • 900 SUNSET DR

    LA GRANDE, OR 978501362

    Phone: (541) 963-1883

    Fax: (541) 963-1837

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100317000553IObstetrics/GynecologyORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97850)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547170789View full group profile
NameSpecialtyState
Physician AssistantOR
Cardiovascular Disease (Cardiology)OR
Internal MedicineOR
Family PracticeOR
Diagnostic RadiologyUT
-OR
-OR
Clinical Social WorkerOR
Physician AssistantCO
O B S T E T R I C S/ G Y N E C O L O G YOR

Reviews

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Frequently asked questions

Is there an official ID for STACY LEILANI WHITAKER (DO) in U.S. healthcare records?
The official identifier for STACY LEILANI WHITAKER (DO) is NPI 1316064512.
Would STACY LEILANI WHITAKER (DO) appear as active to a payer?
You can treat STACY LEILANI WHITAKER (DO) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe STACY LEILANI WHITAKER (DO)'s focus?
For STACY LEILANI WHITAKER (DO), the primary taxonomy reads as Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with STACY LEILANI WHITAKER (DO)?
Directory geography for STACY LEILANI WHITAKER (DO) centers on La Grande, Oregon.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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