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LACY R STARK PA
NPI 1922510205
Nurse Practitioner in Fort Worth, TX

Active since October 26, 2017PECOS EnrolledAccepts Medicare Assignment
1307 8TH AVE, SUITE 608, FORT WORTH, TX 76104(817) 921-4191(817) 429-7783 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 29, 2024, Apr 28, 2021, Oct 26, 2017 (3 updates tracked since 2017).

About Lacy R Stark Pa NPPES

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

LACY R STARK PA (NPI 1922510205) is an individual nurse practitioner in Fort Worth, Texas, licensed in Texas (AP135511) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Fort Worth, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922510205
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLACY R STARKCredential: PA
Location Address1307 8TH AVE, SUITE 608Fort Worth, TX 76104-4140
Mailing Address1307 8th Ave, Suite 608Fort Worth, TX 76104-4140 · (817) 921-4191 · Fax (817) 429-7783
Phone(817) 921-4191
Fax(817) 429-7783
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateOctober 26, 2017
Last NPPES UpdateApril 29, 20243 updates tracked since enumeration
NPPES CertifiedApril 28, 2021
✔ NPI 1922510205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in TX · AP135511
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1307 8TH AVE, Fort Worth, TX 76104
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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

Lacy R Stark Pa 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 ID7416480876
PECOS Enrollment IDI20241024001258
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 Lacy Stark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical Neuroscience PA
Same address
Neurology
1307 8TH AVE STE 608
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 3 clinicians in this Medicare group
NPI 1760459671 (817) 921-4191

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

Hospital Affiliations CMS Care Compare

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

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450135
Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

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.

RICHARD M VIGNESS M. D.
Specialist
1307 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 926-3320
LYDIA A LUNA M.D., P. A.
Obstetrics & Gynecology
1307 8TH AVE, #602
FORT WORTH, TX 76104
Tarrant County (817) 877-1848
MARY MILAM MD
Internal Medicine (Hematology & Oncology)
1307 8TH AVE, SUITE 205
FORT WORTH, TX 76104
Tarrant County (817) 924-4300
J. JOHN STASIKOWSKI, MD PA
Specialist
1307 8TH AVE, SUITE 202
FORT WORTH, TX 76104
Tarrant County (817) 926-8002
CHARLES G. LANGHAM III, M.D., P.A.
Obstetrics & Gynecology
1307 8TH AVE, 201
FORT WORTH, TX 76104
Tarrant County (817) 921-6091
DR. THOMAS A. LEAVENS M.D.
Psychiatry & Neurology (Neurology)
1307 8TH AVE, #408
FORT WORTH, TX 76104
Tarrant County (817) 921-4191
DR. ARTHUR G GARCIA MD
Specialist
1307 8TH AVE, SUITE 507
FORT WORTH, TX 76104
Tarrant County (817) 924-2216
MARY MILAM, M.D., P.A.
Internal Medicine (Hematology & Oncology)
1307 8TH AVE, SUITE 205
FORT WORTH, TX 76104
Tarrant County (817) 924-4300

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 Lacy Stark's NPI number?

The NPI number for Lacy Stark is 1922510205. It was assigned to this individual provider in the NPPES registry on October 26, 2017.

Where is Lacy Stark located?

Lacy Stark practices at 1307 8th Ave Suite 608, Fort Worth, TX 76104. The listed phone number is (817) 921-4191.

What is Lacy Stark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lacy Stark enrolled in Medicare?

Yes. Lacy Stark 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 organization bills Medicare for Lacy Stark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lacy Stark reassigns Medicare benefits to Clinical Neuroscience PA (Fort Worth, TX). The 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 Lacy Stark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lacy Stark accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Lacy Stark 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.

Is Lacy Stark affiliated with any hospitals?

According to CMS data, Lacy Stark is affiliated with Texas Health Harris Methodist Hospital Fort Worth.

When was this NPI record last updated?

The NPPES record for Lacy Stark was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.