JEFF L PUGACH (MD) – Pediatric Urology Physician, NPI 1871589978

JEFF L PUGACH (MD) is a healthcare provider. based in Fort worth, Texas. specializing in UROLOGY. They hold the professional credentials MD. They hold a License No. L3077 (TX). The NPI Number for JEFF L PUGACH (MD) is 1871589978

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
JEFF L PUGACH (MD)
NPI
1871589978
Phone
(682) 885-1855
Address
PO BOX 99371
Enumeration Date
23 September 2005
Last Update Date
13 April 2021

Doctor Profile

Medical School Name
RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Secondary Phone
6828856000
Graduation Year
1991 (35 years ago)
PAC ID
7012800147
Group Practice PAC ID
7719884584
Professional Enrollment ID
I20040203001099
Address ID
TX760926613SO2727XBLVD400

Contacts

Secure Messaging
jpugach16337@CookChildrens.direct-ci.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

861 UROLOGY in TX

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Provider Addresses for JEFF L PUGACH (MD)

  • FT, R 42, Zieglöde, Frauenzell, Wiesent, Wörth an der Donau (VGem), Landkreis Regensburg, Bavaria, 93109, Germany

    FORT WORTH, TX 761990371

    Phone: (682) 885-1855

    Fax: (682) 885-7347

    Type: Mailing

  • 8th Avenue, Fort Worth, Tarrant County, Texas, 76110, United States

    FORT WORTH, TX 761042515

    Phone: (682) 303-0376

    Fax: (682) 303-0377

    Type: Location

  • PO BOX 733784

    DALLAS, TX 753733784

    Phone: (682) 885-1855

    Fax: (682) 885-1396

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $35.

Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.

Last reported payment date: 2023-10-04 • Largest payer in this snapshot: COLOPLAST CORP ($35).

Total Amount

$35

General + Research + Ownership

Payments

2

Total payment records

General Amount

$35

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
COLOPLAST CORP$35
View all Open Payments →|Open Payments Risk Radar →

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: 2004-02-03

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
I20040203001099IUrologyTXTBD

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 76199)

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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: 7719884584View full group profile
NameSpecialtyState
Pediatric Medicine, Cardiac ElectrophysiologyTX
-OK
-TX
H O S P I T A L I S TVA
-TX
-TX
-TX
Pulmonary Disease, Pediatric MedicineTX
-TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

How is JEFF L PUGACH (MD) identified in CMS data?
CMS-hosted NPPES data lists JEFF L PUGACH (MD) with NPI 1871589978.
Does CMS list JEFF L PUGACH (MD) as active?
Yes — JEFF L PUGACH (MD) is active in the NPI listing used on this page.
What taxonomy line describes JEFF L PUGACH (MD)?
For research purposes, treat JEFF L PUGACH (MD) as Pediatric Urology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect JEFF L PUGACH (MD) on a map?
Expect Fort Worth, Texas as a primary anchor for JEFF L PUGACH (MD) unless the record lists multiple sites.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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