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MR. STACY LEE BLACK DDS PA
NPI 1063423085
Dentist - General Practice in Rusk, TX

Active since August 11, 2006PECOS Enrolled
132 HATCHETT ST., RUSK, TX 75785(903) 683-5751(903) 683-3455 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Stacy Lee Black Dds Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. STACY LEE BLACK DDS PA (NPI 1063423085) is an individual general practice provider in Rusk, Texas, licensed in Texas (17132) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063423085
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMR. STACY LEE BLACKCredential: DDS PA
Location Address132 HATCHETT ST.Rusk, TX 75785
Mailing AddressPo Box 316Rusk, TX 75785-0316 · (903) 683-5751 · Fax (903) 683-3455
Phone(903) 683-5751
Fax(903) 683-3455
Sole ProprietorNo
Enumeration DateAugust 11, 2006
Last NPPES UpdateMay 28, 2025
NPPES CertifiedMay 28, 2025
✔ NPI 1063423085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 17132
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
132 HATCHETT ST., Rusk, TX 75785
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Other Identifiers 2

Other36871TX · Dent
Medicaid009120901TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental PPO, Humana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Stacy Lee Black Dds Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75785 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Black's NPI number?

The NPI number for Stacy Black is 1063423085. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Stacy Black located?

Stacy Black practices at 132 Hatchett St., Rusk, TX 75785. The listed phone number is (903) 683-5751.

What is Stacy Black's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Stacy Black enrolled in Medicare?

Yes. Stacy Black is registered in the Medicare PECOS enrollment system.

What insurance does Stacy Black accept?

Health plans from Delta Dental PPO and Humana list Stacy Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacy Black was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.