DR. JACK B IV STEPHENSON (M.D.) – Surgery of the Hand (Plastic Surgery) Physician, NPI 1972624542
Surgery of the Hand (Plastic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
588 PLASTIC AND RECONSTRUCTIVE SURGERY in TX
Provider Addresses for DR. JACK B IV STEPHENSON (M.D.)
23960 KATY FREEWAY
SUITE 380
KATY, TX 77494
Phone: (832) 232-4263
Fax: (844) 342-4263
Type: Mailing
1327 Troup Hwy
Tyler, TX 757014443
Phone: (903) 606-8840
Type: Location
23960 Katy Freeway
Suite 380
Katy, TX 77494
Phone: (832) 232-4263
Fax: (844) 342-4263
Type: Location
8591 S BROADWAY AVE
TYLER, TX 757035470
Phone: (903) 596-9173
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $275.
Total Amount is formed as General ($275) + Research ($0) + Ownership ($0) = $275.
Last reported payment date: 2024-07-31 • Largest payer in this snapshot: AXOGEN ($118).
Total Amount
$275
General + Research + Ownership
Payments
5
Total payment records
General Amount
$275
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AXOGEN | $118 |
| Pylant Medical | $105 |
| Pacira Pharmaceuticals Incorporated | $22 |
| Bioventus LLC | $15 |
| DePuy Synthes Sales Inc. | $14 |
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: 2014-08-26
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 |
|---|---|---|---|---|
| I20140826000332 | I | Plastic And Reconstructive Surgery | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 197 | 150 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 144 | 144 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 79 | 71 | $0 |
| 20550 | Injection into tendon or ligament | 73 | 56 | $0 |
| 64721 | Release and/or relocation of hand nerve | 55 | 51 | $0 |
Insurance plans in this area (ZIP 77494)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | AZ | |
| Internal Medicine | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| - | TX | |
| E N D O C R I N O L O G Y | TX | |
| Nurse Practitioner | IL | |
| - | NC | |
| Physician Assistant | LA | |
| Hospitalist, Gastroenterology | TX |
Reviews
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