STACY PHILIP (MD) – Family Medicine Physician, NPI 1366025207
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,775 FAMILY PRACTICE in OK
Provider Addresses for STACY PHILIP (MD)
1200 W Cherokee St
Wagoner, OK 744674624
Phone: (918) 485-5514
Fax: (918) 485-1383
Type: Location
1200 W CHEROKEE ST
WAGONER, OK 744674624
Phone: (918) 485-5514
Type: Mailing
3138 S GARNETT RD
TULSA, OK 741461933
Phone: (918) 203-7005
Fax: (918) 400-0967
Type: Location
7501 RIVERSIDE PKWY
TULSA, OK 741365056
Phone: (918) 710-4200
Fax: (918) 403-6331
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $63.
Total Amount is formed as General ($63) + Research ($0) + Ownership ($0) = $63.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($25).
Total Amount
$63
General + Research + Ownership
Payments
3
Total payment records
General Amount
$63
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sumitomo Pharma America, Inc. | $25 |
| Exact Sciences Corporation | $23 |
| Organon LLC | $15 |
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: 2025-08-18
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 |
|---|---|---|---|---|
| I20230217002784 | I | Family Practice | OK | TBD |
| I20250818000062 | I | Family Practice | WI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74467)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery, Thoracic Surgery, Vascular Surgery | MO | |
| Physical Therapist In Private Practice | OK | |
| G A S T R O E N T E R O L O G Y | OK | |
| Family Practice | OK | |
| Infectious Disease | OK | |
| Otolaryngology, Allergy/Immunology | OK | |
| Orthopedic Surgery | AR | |
| Family Practice, Emergency Medicine | OK | |
| - | OK | |
| Psychiatry, Geriatric Psychiatry | OK |
Reviews
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