Individual provider Active NPI

Stacy R. Moretta, P.A.

  • Medical Physician Assistant
  • Irving, TX
National Provider Identifier
1639309461
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA06061 Issued in TX
Practice address
6161 N State Highway 161
Irving, TX 75038
Phone
(972) 258-7499
Fax
(972) 257-0897
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06061 TX Primary

Addresses

Primary practice location

6161 N State Highway 161
Irving, TX 75038

Mailing address

6161 N State Highway 161
Irving, TX 75038-2220
Phone (972) 258-7499

Other practice location 1

6565 West Loop S Ste 525
Bellaire, TX 77401-3519
Phone (346) 971-4050

Other identifiers 1

IdentifierTypeStateIssuer
467551YZNAOtherTXMEDICARE NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160119001877 TX Practitioner - Physician Assistant 8123252244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
The ENT and Allergy Centers of Texas, PLLCGroup PAC ID 4385709054, 56 clinicians
Contemporary Medicine Associates, PLLCGroup PAC ID 6002964285, 29 clinicians

Practice addresses (Care Compare)

1130 Beachview St
Suite 240
Dallas, TX 75218-3703
Phone (214) 324-0418

5220 W University Dr
Suite 150
McKinney, TX 75071-7418
Phone (972) 984-1050

6565 W Loop S
Suite 525
Bellaire, TX 77401-3519
Phone (713) 677-2475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06061TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Richard D Thrasher III MD PA Past Accepting new patients
White Rock ENT PA PastSince Oct 25, 2011 Accepting new patients

Organizations & group practices 4

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1639309461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 N STATE HIGHWAY 161",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382220",
            "telephone_number": "972-258-7499",
            "fax_number": "972-257-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 N STATE HIGHWAY 161",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75038",
            "telephone_number": "972-258-7499",
            "fax_number": "972-257-0897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 West Loop S Ste 525",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774013519",
            "country_code": "US",
            "telephone_number": "346-971-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORETTA",
        "first_name": "STACY",
        "middle_name": "R.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "467551YZNA",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.