LACY R STARK (PA) – Nurse Practitioner, NPI 1922510205
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for LACY R STARK (PA)
1307 8TH AVE STE 408
FORT WORTH, TX 761044143
Phone: (817) 921-4191
Fax: (817) 926-6045
Type: Location
713, Grainger Street, Fort Worth, Tarrant County, Texas, 76104, United States
FORT WORTH, TX 761043261
Phone: (817) 336-3968
Fax: (817) 335-3402
Type: Location
1307 8TH AVE
SUITE 608
FORT WORTH, TX 761044140
Phone: (817) 921-4191
Fax: (817) 429-7783
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 194 Open Payments records for all available years, with a total value of $3,285.
Total Amount is formed as General ($3,285) + Research ($0) + Ownership ($0) = $3,285.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($725).
Total Amount
$3,285
General + Research + Ownership
Payments
194
Total payment records
General Amount
$3,285
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $725 |
| Novartis Pharmaceuticals Corporation | $200 |
| PFIZER INC. | $153 |
| Lilly USA, LLC | $138 |
| Biogen, Inc. | $116 |
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: 2024-10-24
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 |
|---|---|---|---|---|
| I20241024001258 | 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 |
|---|---|---|
| - | TX |
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