DR. SHANE M TACKITT DO
NPI 1588035976
Internal Medicine in Mansfield, TX

Q: What is Shane Tackitt's NPI number?

The NPI number for Shane Tackitt is 1588035976. It was assigned to this individual provider in the NPPES registry on October 12, 2015.

Q: What is Shane Tackitt's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Tackitt was last updated on July 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since October 12, 2015PECOS EnrolledAccepts Medicare Assignment

2700 E BROAD ST, MANSFIELD, TX 76063(682) 242-6470(682) 622-2092 Get Directions Write a Review

NPPES record last updated: July 1, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 1, 2020, Mar 18, 2020, May 22, 2017 and 1 more (4 updates tracked since 2017).

On this page

About Dr. Shane M Tackitt Do NPPES

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

DR. SHANE M TACKITT DO (NPI 1588035976) is an individual internal medicine provider in Mansfield, Texas, licensed in Texas (S5274) and active in the NPI registry since October 2015. He is enrolled in Medicare PECOS, is affiliated with Methodist Mansfield Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1588035976

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. SHANE M TACKITTCredential: DO

Location Address2700 E BROAD STMansfield, TX 76063-5899

Mailing Address2700 E Broad St, Department Internal MedicineMansfield, TX 76063-5899 · (682) 242-6470 · Fax (682) 622-2092

Phone(682) 242-6470

Fax(682) 622-2092

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 12, 2015

Last NPPES UpdateJuly 1, 20204 updates tracked since enumeration

NPPES CertifiedJuly 1, 2020

✔ NPI 1588035976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TX · S5274

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License S5274 (TX)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License BP10058725 (TX), S5274 (TX)

2700 E BROAD ST, Mansfield, TX 76063

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shane M Tackitt Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830468032

PECOS Enrollment IDI20200519003055

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.

Medicare Billing Reassignment

Medicare enrollment records show Shane Tackitt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lonestar Hospital Medicine Associates, PA

Same address

Hospitalist

2700 E BROAD ST
Mansfield, TX 76063

Reassigned Medicare billing, Texas enrollment
994 clinicians in this Medicare group

NPI 1518237429 (682) 622-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

344 services133 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

157 services82 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

141 services136 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Mansfield Medical Center

Acute Care Hospitals · Mansfield, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670023

Location2700 E Broad StreetMansfield, TX 76063 · Tarrant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76063 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

$129.63 typical visit price

range $56.47 – $171.07

Typical copayment $32.40 (range $14.11 – $42.76)

Most-billed visit code 99204

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

9 suppliers68 claims68 services$15.03 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

9 suppliers76 claims76 services$64.62 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRETCHEN M BURES MD

Internal Medicine