STACI M HESTDALEN (M.D.) – Dermatology Physician, NPI 1194790006
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
393 DERMATOLOGY in WA
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Provider Addresses for STACI M HESTDALEN (M.D.)
1807, North Hutchinson Road, Greenrich Village Apartments, Spokane Valley, Spokane County, Washington, 99212, United States
SPOKANE VALLEY, WA 992122444
Phone: (509) 456-7414
Fax: (509) 624-0763
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)
CMS reports 84 Open Payments records for all available years, with a total value of $1,609.
Total Amount is formed as General ($1,609) + Research ($0) + Ownership ($0) = $1,609.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($368).
Total Amount
$1,609
General + Research + Ownership
Payments
84
Total payment records
General Amount
$1,609
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $368 |
| Janssen Biotech, Inc. | $257 |
| Lilly USA, LLC | $241 |
| Galderma Laboratories, L.P. | $92 |
| Amgen Inc. | $71 |
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: 2011-11-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040623001603 | I | Dermatology | WA | TBD |
| I20111128000739 | I | Dermatology | ID | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 749 | 652 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 596 | 153 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 297 | 259 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 215 | 196 | $0 |
| 96900 | Application of ultraviolet light to skin | 152 | 17 | $0 |
Insurance plans in this area (ZIP 99212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OR | |
| Physician Assistant | NV | |
| Physician Assistant | ID | |
| D E R M A T O L O G Y | NV | |
| - | AK | |
| - | ID | |
| D E R M A T O L O G Y | OH | |
| Physician Assistant | TX | |
| Physician Assistant | OR | |
| Physician Assistant | OR |
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