ERIC R STARK (MD) – Family Medicine Physician, NPI 1134198252
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ERIC R STARK (MD)
1115 SE 164TH AVE DEPT 358
VANCOUVER, WA 986838004
Phone: (360) 729-1462
Fax: (360) 729-3104
Type: Mailing
Family Medicine, 1201, West Agency Road, West Burlington, Des Moines County, Iowa, 52655, United States
835 EAST FAIRHAVEN AVENUE
BURLINGTON, WA 982330329
Phone: (360) 856-7960
Fax: (360) 755-1405
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: 2010-09-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100917001002 | I | Family Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98683)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Sports Medicine | WA | |
| Family Practice | GA | |
| - | WA | |
| Family Practice | OH | |
| Cardiovascular Disease (Cardiology), Internal Medicine | WA | |
| - | WA | |
| Physician Assistant | IN | |
| Gastroenterology, Internal Medicine | WA | |
| Cardiovascular Disease (Cardiology) | WA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | WA |
Reviews
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