KEVIN B STACKS (MD) – Emergency Medicine Physician, NPI 1679596423

KEVIN B STACKS (MD) is a healthcare provider. based in Fort worth, Texas. specializing in Emergency Medicine Physician. They hold the professional credentials MD. They hold a License No. K7908 (TX). The NPI Number for KEVIN B STACKS (MD) is 1679596423

Main info

Male
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN B STACKS (MD)
NPI
1679596423
Phone
(817) 451-4208
Address
PO BOX 24921
Enumeration Date
25 July 2006
Last Update Date
30 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
9728100700
Graduation Year
1997 (29 years ago)
PAC ID
1153384193
Group Practice PAC ID
3375859408
Professional Enrollment ID
I20041111000752
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for KEVIN B STACKS (MD)

  • PO BOX 24921

    FORT WORTH, TX 761241921

    Phone: (817) 451-4208

    Type: Mailing

  • 864 PRESTON RD

    DENISON, TX 750200775

    Phone: (903) 624-6514

    Type: Mailing

  • Wilson N. Jones Regional Medical Center, 500, North Highland Avenue, Sherman, Grayson County, Texas, 75092, United States

    SHERMAN, TX 750927354

    Phone: (903) 870-4122

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-11-11

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
I20041111000752IEmergency MedicineTXTBD

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 76124)

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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: 3375859408View full group profile

Reviews

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Frequently asked questions

What number should I use to identify KEVIN B STACKS (MD) for billing?
Administrative and clinical systems typically use NPI 1679596423 for KEVIN B STACKS (MD).
Does the public listing show KEVIN B STACKS (MD) as active?
KEVIN B STACKS (MD)'s NPI record reflects an active status in NPPES.
What type of care does KEVIN B STACKS (MD) provide?
KEVIN B STACKS (MD)'s profile centers on Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit KEVIN B STACKS (MD) in Fort Worth, Texas?
For routing, start with Fort Worth, Texas for KEVIN B STACKS (MD), then verify phone and hours locally.
Why is information missing for KEVIN B STACKS (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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