STACI GOTTLIEB RN, MSN, PMHNP
NPI 1699052555
Nurse Practitioner - Psychiatric/Mental Health in Fort Worth, TX
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
Specialties & Licenses
Other Identifiers 4
Accepted 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
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.
Medicare Billing Reassignments
3Medicare enrollment records show Staci Gottlieb reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Cook Childrens Physician Network
- 1,186 clinicians in this Medicare group
Fort Worth, TX 76107
- Reassigned Medicare billing, Texas enrollment
- 165 clinicians in this Medicare group
Wichita Falls, TX 76301
- Reassigned Medicare billing, Texas enrollment
- 51 clinicians in this Medicare group
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
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.
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.
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.
FORT WORTH, TX 76104
FORT WORTH, TX 76104
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.
Which organizations bill Medicare for Staci Gottlieb's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Staci Gottlieb reassigns Medicare benefits to 3 organizations: Cook Children's Physician Network (Fort Worth, TX), My Health My Resources Of Tarrant County (Fort Worth, TX) and Helen Farabee Centers (Wichita Falls, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Staci Gottlieb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Staci Gottlieb accept?
Health plans from Blue Cross and Blue Shield of Texas 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.
# Staci Gottlieb, RN, MSN, PMHNP · NPI 1699052555
Psychiatric/Mental Health physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since November 7, 2011.
## Identity
- **NPI:** 1699052555 (Entity type: Individual)
- **Enumerated:** November 7, 2011
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 741675 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 901 7TH AVE, SUITE 230, Fort Worth, TX 76104-2722
- **Phone:** (682) 885-1050 · **Fax:** (682) 885-7572
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Cook Children's Physician Network (NPI 1083472062, Fort Worth, TX); My Health My Resources Of Tarrant County (NPI 1952423782, Fort Worth, TX); Helen Farabee Centers (NPI 1457479511, Wichita Falls, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** July 29, 2016
- **Other identifiers:** Medicaid 293955505 (TX); Other 8600NA (TX); Medicaid 293955504 (TX); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1699052555) · Data from the CMS NPPES public registry.