Soni Elizabeth Stake, MD is a medicare enrolled "General Practice" physician in Douglas, Arizona. Her current practice location is
100 E 5th St, Douglas, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 364-7659.
Soni Elizabeth Stake is licensed to practice in Arizona (license number 40468) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487844395.
Physician's Profile
| Full Name | Soni Elizabeth Stake |
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| Gender | Female |
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| Speciality | General Practice |
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| Location | 100 E 5th St, Douglas, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1487844395
- Provider Enumeration Date: 07/26/2007
- Last Update Date: 09/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 7012082589
- Enrollment ID: I20080818000644
Medical Identifiers
Medical identifiers for Soni Elizabeth Stake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487844395 | NPI | - | NPPES |
| 362117 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 40468 (Arizona) | Secondary |
| 208600000X | Surgery | 40468 (Arizona) | Secondary |
| 208D00000X | General Practice | 40468 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Soni Elizabeth Stake allows following entities to bill medicare on her behalf.
| Entity Name | Bisbee Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518968767
PECOS PAC ID: 5092626168
Enrollment ID: O20040623001007 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Soni Elizabeth Stake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Soni Elizabeth Stake, MD
3815 E Edna Ave,
Phoenix, AZ 85032-2101
Ph: (313) 570-1752 | Soni Elizabeth Stake, MD
100 E 5th St,
Douglas, AZ 85607-2859
Ph: (520) 364-7659 |
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