STACY BEATY (MD) – Dermatology Physician, NPI 1669499638

STACY BEATY (MD) is a healthcare provider. based in St louis, Missouri. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 2005004429 (MO). The NPI Number for STACY BEATY (MD) is 1669499638

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
STACY BEATY (MD)
NPI
1669499638
Phone
(314) 977-6828
Address
3691 RUTGER AVE
Enumeration Date
16 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
8172817546315
Graduation Year
2001 (25 years ago)
PAC ID
0749215697
Group Practice PAC ID
6002801164
Professional Enrollment ID
I20101007001328
Address ID
TX760543131HU1733XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

337 DERMATOLOGY in MO

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Provider Addresses for STACY BEATY (MD)

  • 3691 RUTGER AVE

    PROVIDER ENROLLMENT

    ST LOUIS, MO 63110

    Phone: (314) 977-6828

    Fax: (314) 977-6777

    Type: Mailing

  • Place Saint-Louis, Little France, Centre, Strasbourg, Bas-Rhin, European Collectivity of Alsace, Grand Est, Metropolitan France, 67000, France

    ST LOUIS, MO 63104

    Phone: (314) 256-3433

    Fax: (314) 256-3431

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 212 Open Payments records for all available years, with a total value of $4,053.

Total Amount is formed as General ($4,053) + Research ($0) + Ownership ($0) = $4,053.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Janssen Biotech, Inc. ($1,036).

Total Amount

$4,053

General + Research + Ownership

Payments

212

Total payment records

General Amount

$4,053

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2010-10-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101007001328IDermatologyTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths37075$0
99213Established patient office or other outpatient visit, 20-29 minutes359295$0
17110Destruction of skin growth, 1-14 growths183143$0
17000Destruction of precancer skin growth, 1 growth130107$0
11102Biopsy of related skin growth, first growth120102$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002801164View full group profile
NameSpecialtyState
D E R M A T O L O G YTX
D E R M A T O L O G YTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for STACY BEATY (MD)?
STACY BEATY (MD) — NPI 1669499638 — is the standard way to identify this listing.
Does the file indicate STACY BEATY (MD) is practicing under active NPI?
Directory data currently reports STACY BEATY (MD) as active.
What is STACY BEATY (MD) best known for clinically?
Directory data describes STACY BEATY (MD) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does STACY BEATY (MD) list a practice location?
Patients near St Louis, Missouri may find STACY BEATY (MD) in results; validate coverage separately.
Why does STACY BEATY (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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