Individual provider Active NPI

Rebecca Kinney Stephenson, MD

  • Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1598781122
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L9503 Issued in TX
Practice address
1500 S Main St Ste 303
Fort Worth, TX 76104-4917
Phone
(817) 702-1172
Fax
(817) 702-1605
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L9503 TX Primary
Surgical Oncology Physician 2086X0206X L9503 TX

Addresses

Primary practice location

1500 S Main St Ste 303
Fort Worth, TX 76104-4917

Mailing address

PO Box 732973
Dallas, TX 75373-7329

Other identifiers 2

IdentifierTypeStateIssuer
P00254219OtherRAILROAD MEDICARE
168027402MedicaidTX

Other names 1

  • Gerald Robert Stephenson Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729001515 TX Practitioner - General SurgeryPractitioner - Surgical Oncology 5597735167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Johns Hopkins University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1166

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Dec 8, 2017 Accepting new patients
Tarrant County Hospital District Past Accepting new patients

Locations

601 W Sanford St
Arlington, TX 76011
Phone (817) 861-0095

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

1500 S Main St
Fl 2
Ft Worth, TX 76104
Phone (817) 702-3000

1450 8th Ave
Ft Worth, TX 76104
Phone (817) 702-8300

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1598781122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753737329",
            "fax_number": "817-702-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST STE 303",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1172",
            "fax_number": "817-702-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "REBECCA",
        "middle_name": "KINNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L9503",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "L9503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00254219",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168027402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERALD",
            "last_name": "STEPHENSON",
            "middle_name": "ROBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.