Stanley R Stacy, DO

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

3054 Issued in OK

Practice address

10106 S Sheridan Rd
Tulsa, OK 74133-6775

Phone

(918) 619-9400

NPI assigned

Jan 19, 2006

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: General Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Doctor Immediate Care LLCGroup PAC ID 1557523131, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• My Doctor Immediate Care LLC

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1992440622
  Medicare reassignment Care Compare group NPD Authorized official
• My Doctor Family Care, LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1316629868
  Medicare reassignment NPD Authorized official
• Brian Kent MD Inc PC

  • Plastic Surgery Physician
  • Tulsa, OK
  • NPI 1043613300
  NPD (past)
• Southcrest Emergency Physicians PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tulsa, OK
  • NPI 1205816048
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1225018757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10106 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336775",
            "telephone_number": "918-230-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10106 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336775",
            "telephone_number": "918-619-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "STANLEY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "3054",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "3054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Mitchell
• Cory Elizabeth Stacy
• Kimberly Stacy, LPN
• Mark Stacy Jr.
• Mary Cassidy Stacy
• Jessica Kay Stadler, FNP-C
• John Kellen Stadler, DO
• Andrea Elizabeth Stafford, M.D.
• Gregory Lee Stafford, PA-C
• Jackie Dee Stafford, APRN

• Emergency Medical Services (Emergency Medicine) Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.