JESSICA STODIECK (AGACNP) – Acute Care Nurse Practitioner, NPI 1073056370
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JESSICA STODIECK (AGACNP)
Mistletoe Boulevard, Fort Worth, Tarrant County, Texas, 76110, United States
FORT WORTH, TX 761044048
Phone: (817) 338-1300
Type: Mailing
209 OLD HIGHWAY 1187
BURLESON, TX 760280281
Phone: (682) 268-6700
Fax: (682) 268-6701
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 43 Open Payments records for all available years, with a total value of $1,145.
Total Amount is formed as General ($1,145) + Research ($0) + Ownership ($0) = $1,145.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($360).
Total Amount
$1,145
General + Research + Ownership
Payments
43
Total payment records
General Amount
$1,145
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novartis Pharmaceuticals Corporation | $360 |
| Abbott Laboratories | $172 |
| Merck Sharp & Dohme LLC | $143 |
| PFIZER INC. | $133 |
| AstraZeneca Pharmaceuticals LP | $67 |
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: 2017-05-24
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 |
|---|---|---|---|---|
| I20170524002211 | I | Nurse Practitioner | TX | 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 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology) | TX | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IN | |
| Interventional Cardiology | TX | |
| - | TX | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | IA | |
| Nurse Practitioner | TX | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | TX | |
| - | TX | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | AL | |
| Physician Assistant | TX |
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