STACY D. HOLTZ (PA-C) – Physician Assistant, NPI 1487637674
Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,243 PHYSICIAN ASSISTANT in CT
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Provider Addresses for STACY D. HOLTZ (PA-C)
245, Jeremy Swamp Road, Kettletown, Southford, Southbury, Naugatuck Valley Planning Region, Connecticut, 06488, United States
SOUTHBURY, CT 064882360
Phone: (203) 267-5212
Fax: (203) 267-5212
Type: Mailing
Church of God New Testament Church, 64, Robbins Street, West Side Hill, Waterbury, New Haven County, Connecticut, 06708, United States
SUITE 7004
WATERBURY, CT 06721
Phone: (203) 573-7307
Fax: (203) 573-6555
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $1,403.
Total Amount is formed as General ($1,403) + Research ($0) + Ownership ($0) = $1,403.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: Kerecis Limited ($435).
Total Amount
$1,403
General + Research + Ownership
Payments
13
Total payment records
General Amount
$1,403
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $435 |
| Davol Inc. | $325 |
| Stryker Corporation | $324 |
| Medical Device Business Services, Inc. | $137 |
| Heron Therapeutics, Inc. | $120 |
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: 2008-11-26
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 |
|---|---|---|---|---|
| I20081126000532 | I | Physician Assistant | CT | 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 | 15 | 15 | $0 |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 13 | 13 | $0 |
Insurance plans in this area (ZIP 06488)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CT | |
| Nurse Practitioner | CT | |
| Nurse Practitioner | CT | |
| - | CT | |
| - | CT | |
| - | CT | |
| Internal Medicine | CT | |
| Internal Medicine | CT | |
| Nurse Practitioner | CT | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | CT |
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