DOUGLAS S STACEY (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1144212085

DOUGLAS S STACEY (DPM) is a healthcare provider. based in Henderson, Nevada. specializing in Foot & Ankle Surgery Podiatrist. They hold the professional credentials DPM. They hold a License No. 8601 (NV). The NPI Number for DOUGLAS S STACEY (DPM) is 1144212085

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
DOUGLAS S STACEY (DPM)
NPI
1144212085
Phone
(702) 456-3668
Address
10561 JEFFREYS ST
Enumeration Date
17 August 2005
Last Update Date
3 February 2014

Doctor Profile

Medical School Name
CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
7024563668
Graduation Year
1984 (42 years ago)
PAC ID
0547253346
Group Practice PAC ID
1759374556
Professional Enrollment ID
I20040416000514
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DOUGLAS S STACEY (DPM)

  • 10561, Jeffreys Street, Seven Hills, Henderson, Clark County, Nevada, 89052, United States

    #110

    HENDERSON, NV 890524266

    Phone: (702) 456-3668

    Fax: (702) 456-6688

    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 1 Open Payments records for all available years, with a total value of $58.

Total Amount is formed as General ($58) + Research ($0) + Ownership ($0) = $58.

Last reported payment date: 2024-02-12 • Largest payer in this snapshot: Integra LifeSciences Corporation ($58).

Total Amount

$58

General + Research + Ownership

Payments

1

Total payment records

General Amount

$58

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-12

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2004-04-16

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
I20040416000514IPodiatryNVTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89052)

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Provider's Procedures

DOUGLAS S STACEY (DPM) performs procedures in Foot & Ankle Surgery Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYNV11042Removal of skin and tissue first 20 sq cm or less3713

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: 1759374556View full group profile
NameSpecialtyState
P O D I A T R YNV
P O D I A T R YNV
P O D I A T R YNV

Reviews

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Frequently asked questions

What is the 10-digit NPI for DOUGLAS S STACEY (DPM)?
DOUGLAS S STACEY (DPM) — NPI 1144212085 — is the standard way to identify this listing.
Does the file indicate DOUGLAS S STACEY (DPM) is practicing under active NPI?
Directory data currently reports DOUGLAS S STACEY (DPM) as active.
What taxonomy line describes DOUGLAS S STACEY (DPM)?
For research purposes, treat DOUGLAS S STACEY (DPM) as Foot & Ankle Surgery Podiatrist in this dataset. Clinical services aligned with this taxonomy classification.
Where is DOUGLAS S STACEY (DPM) based?
DOUGLAS S STACEY (DPM) is tied to Henderson, Nevada in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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