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STACI GOTTLIEB RN, MSN, PMHNP
NPI 1699052555
Nurse Practitioner - Psychiatric/Mental Health in Fort Worth, TX

Active since November 07, 2011PECOS EnrolledAccepts Medicare Assignment
901 7TH AVE, SUITE 230, FORT WORTH, TX 76104(682) 885-1050(682) 885-7572 Get Directions Write a Review

NPPES record last updated: July 29, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Staci Gottlieb Rn, Msn, Pmhnp NPPES

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

STACI GOTTLIEB RN, MSN, PMHNP (NPI 1699052555) is an individual psychiatric/mental health provider in Fort Worth, Texas, licensed in Texas (741675) and active in the NPI registry since November 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1699052555
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSTACI GOTTLIEBCredential: RN, MSN, PMHNP
Location Address901 7TH AVE, SUITE 230Fort Worth, TX 76104-2722
Mailing AddressPo Box 99371Fort Worth, TX 76199-0371 · (682) 885-1855 · Fax (682) 885-7347
Phone(682) 885-1050
Fax(682) 885-7572
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateNovember 7, 2011
Last NPPES UpdateJuly 29, 2016
✔ NPI 1699052555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in TX · 741675
901 7TH AVE, Fort Worth, TX 76104
Open in Google Maps ↗

Other Identifiers 4

Medicaid293955505TX
Other8600NATX · Bcbs
Medicaid293955504TX
Medicare PIN284030YRK5TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Staci Gottlieb Rn, Msn, Pmhnp 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 ID6800057662
PECOS Enrollment IDI20120423000364
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.

Areas of Expertise CMS Part B claims

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
34 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
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.

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.

MS. YOLANDA VALENZUELA PHD
Psychologist
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-1480
DR. LISA MCKAY BUCKMILLER MD
Otolaryngology (Pediatric Otolaryngology)
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-6850
MEGAN MARIE BURSON CPNP-PC
Nurse Practitioner (Pediatrics)
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-6850
DR. KIA LASHAUN CARTER M.D.
Psychiatry & Neurology (Psychiatry)
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-1050
PEGE R CRANE CPNP
Nurse Practitioner (Pediatrics)
901 7TH AVE, STE 220
FORT WORTH, TX 76104
Tarrant County (682) 885-4007
WHITNEY C DRAGON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-1050
ALLISON GAIL CHISHOLM M.D
Otolaryngology (Pediatric Otolaryngology)
901 7TH AVE
FORT WORTH, TX 76104
Tarrant County (682) 885-6850
KATHLEEN M WHITE PNP
Nurse Practitioner (Pediatrics)
901 7TH AVE, STE 220
FORT WORTH, TX 76104
Tarrant County (682) 885-4007

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 Staci Gottlieb's NPI number?

The NPI number for Staci Gottlieb is 1699052555. It was assigned to this individual provider in the NPPES registry on November 7, 2011.

Where is Staci Gottlieb located?

Staci Gottlieb practices at 901 7th Ave Suite 230, Fort Worth, TX 76104. The listed phone number is (682) 885-1050.

What is Staci Gottlieb's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Staci Gottlieb enrolled in Medicare?

Yes. Staci Gottlieb is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Staci Gottlieb accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Staci Gottlieb 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 Staci Gottlieb was last updated on July 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.