Individual provider Active NPI

Stanly Barten Heckrodt, MD, D.PH.

  • Family Medicine Physician
  • Prosper, TX
National Provider Identifier
1619935962
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E7420 Issued in TX
Practice address
4441 Cotton Belt LN
Prosper, TX 75078-2151
Phone
(361) 652-1935
Fax
(281) 535-2240
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E7420 TX Primary

Addresses

Primary practice location

4441 Cotton Belt LN
Prosper, TX 75078-2151

Mailing address

4441 Cotton Belt LN
Prosper, TX 75078-2151
Phone (361) 652-1935

Other identifiers 3

IdentifierTypeStateIssuer
4330606OtherTXAETNA
P083Y0706MedicaidTX
83U07001OtherTXBCBS

Other names 1

  • Stan Heckrodt Other 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
I20070724000750 TX Practitioner - Family Practice 8729005632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E7420TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pamela D. Morgan Family Medicine Current Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
First Family Clinic, Inc. Family Medicine PastSince Jun 25, 2012 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine Past Accepting new patients

Locations

3023 Marina Bay Dr
Ste 103
League City, TX 77573
Phone (281) 334-5032

Organizations & group practices 5

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1619935962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 COTTON BELT LN",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782151",
            "telephone_number": "361-652-1935",
            "fax_number": "281-535-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 COTTON BELT LN",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782151",
            "telephone_number": "361-652-1935",
            "fax_number": "281-535-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKRODT",
        "first_name": "STANLY",
        "middle_name": "BARTEN",
        "name_prefix": "Dr.",
        "credential": "MD, D.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E7420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4330606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P083Y0706",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83U07001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STAN",
            "last_name": "HECKRODT",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.