DR. STACY LAUREN COULTHARD (M.D.) – Surgery Physician, NPI 1982864179
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,092 GENERAL SURGERY in GA
Provider Addresses for DR. STACY LAUREN COULTHARD (M.D.)
BROOKE ARMY MEDICAL CENTER
3551 ROGER BROOKE DRIVE
JBSA FORT SAM HOUSTON, TX 782344505
Phone: (210) 916-5102
Type: Mailing
825 HIGHLAND LN NE
UNIT 1316
ATLANTA, GA 303064386
Phone: (804) 334-1213
Type: Mailing
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 237082111
Phone: (757) 953-4455
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $1,099.
Total Amount is formed as General ($1,099) + Research ($0) + Ownership ($0) = $1,099.
Last reported payment date: 2024-04-29 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($1,029).
Total Amount
$1,099
General + Research + Ownership
Payments
4
Total payment records
General Amount
$1,099
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $1,029 |
| Prytime Medical Devices, Inc. | $70 |
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: 2024-09-19
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 |
|---|---|---|---|---|
| I20240919003904 | I | General Surgery | PA | 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 78234)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | PA | |
| Pulmonary Disease | PA | |
| Critical Care (Intensivists), Internal Medicine, Pulmonary Disease | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| - | PA | |
| Emergency Medicine | PA | |
| Nurse Practitioner | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| Nurse Practitioner | PA |
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