Individual provider Active NPI

Mary Caroline Stancukas, DPM

  • Foot & Ankle Surgery Podiatrist
  • Burleson, TX
National Provider Identifier
1356757934
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2287 Issued in TX
Practice address
215 Old Highway 1187
Burleson, TX 76028-0281
Phone
(817) 926-2663
Fax
(817) 293-8860
NPI assigned
Jul 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 135000840 IL
Foot & Ankle Surgery Podiatrist 213ES0103X 2287 TX Primary

Addresses

Primary practice location

215 Old Highway 1187
Burleson, TX 76028-0281

Mailing address

215 Old Highway 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Other practice location 1

167 Regency Pkwy Ste 103
Mansfield, TX 76063-6660
Phone (817) 926-2663

Other practice location 2

929 Lipscomb St
Fort Worth, TX 76104-3173
Phone (817) 926-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831001825 TX Practitioner - Podiatry 4587937214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Orthopaedic and Spine Specialists, PLLCGroup PAC ID 5597844951, 19 clinicians

Practice addresses (Care Compare)

215 Old Hwy 1187
Burleson, TX 76028-0281
Phone (817) 926-2663

Merit-based Incentive Payment System (MIPS)

Final score
83.21 of 100Reported as group
Quality
83.88
Promoting interoperability
98
Improvement activities
40
Cost
57.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue65
Removal of skin lesions1-10
Removal of nail tissue555
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135000840ILMDFoot & Ankle Surgery Podiatrist
2287TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Orthopaedic and Spine Specialists, PLLC Foot & Ankle Surgery CurrentSince Dec 1, 2023 Accepting new patients
Lone Star Orthopaedic and Spine Specialists, PLLC Foot & Ankle Surgery CurrentSince Dec 1, 2023 Accepting new patients
Fort Worth Foot and Ankle, PLLC Foot & Ankle Surgery CurrentSince Jan 2, 2022 Accepting new patients

Locations

215 Old Highway 1187
Burleson, TX 76028
Phone 8179262663118

1307 8th Ave
Ste 407
Fort Worth, TX 76104
Phone (817) 776-5333

167 Regency Pkwy
Ste 103
Mansfield, TX 76063
Phone (682) 341-7110

Interoperability endpoints

  • Direct secure messaging: mary.stancukas.1@18396.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18396/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EABGAA

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1356757934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Regency Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636660",
            "country_code": "US",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "929 Lipscomb St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043173",
            "country_code": "US",
            "telephone_number": "817-926-2663",
            "fax_number": "817-293-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANCUKAS",
        "first_name": "MARY",
        "middle_name": "CAROLINE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135000840",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.