STACEY RENEE HAVEMAN (PHYSICIAN ASSISTANT) – Medical Physician Assistant, NPI 1023309796
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
Provider Addresses for STACEY RENEE HAVEMAN (PHYSICIAN ASSISTANT)
55 W TIETAN ST
WALLA WALLA, WA 993624445
Phone: (509) 525-3720
Fax: (509) 522-1592
Mailing address matches the actual address.
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: 2013-11-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131119001214 | I | Physician Assistant | WA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 30 | 28 | $0 |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 22 | 22 | $0 |
Insurance plans in this area (ZIP 99362)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | WA | 27447 | Repair of knee joint | 61 | 60 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| - | CA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| - | FL | |
| - | WA | |
| - | WA | |
| - | WA | |
| - | WA | |
| D E R M A T O L O G Y | WA |
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