STACEY JANTZEN (AGACNP-BC) – Nurse Practitioner, NPI 1760056527
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for STACEY JANTZEN (AGACNP-BC)
816 W CANNON ST
FORT WORTH, TX 761043194
Phone: (817) 321-0391
Type: Mailing
2700 E BROAD ST
MANSFIELD, TX 760635899
Phone: (682) 242-6440
Fax: (682) 242-6445
Type: Location
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 $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-11-06 • Largest payer in this snapshot: Siemens Medical Solutions USA, Inc. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Siemens Medical Solutions USA, Inc. | $20 |
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: 2021-08-14
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 |
|---|---|---|---|---|
| I20210814000436 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 49083 | Drainage of fluid from abdominal cavity using imaging guidance | 134 | 29 | $0 |
| 32555 | Aspiration of fluid from chest cavity using imaging guidance | 59 | 48 | $0 |
| 77001 | Fluoroscopic guidance for insertion or removal of central vein access device | 43 | 37 | $0 |
| 76937 | Ultrasonic guidance for blood vessel access | 37 | 35 | $0 |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 30 | 29 | $0 |
Insurance plans in this area (ZIP 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX |
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