Individual provider Active NPI

Stacey Bruckler, CRNA

  • Certified Registered Nurse Anesthetist
  • Temple, TX
National Provider Identifier
1710208624
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP121712 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-1248
Phone
(254) 724-2111
NPI assigned
Jun 15, 2010
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 082374-23 NH
Certified Registered Nurse Anesthetist 367500000X ARNP9162361 FL
Certified Registered Nurse Anesthetist 367500000X AP121712 TX Primary
Certified Registered Nurse Anesthetist 367500000X 816543 TX

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-1248

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice location 1

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 667-0444 ext. 141

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGOtherFLBCBS
PENDINGMedicaidFL

Other names 1

  • Stacey I Lesky Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbruckler1095363@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN, NH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120809000928 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163547290 Reassigns benefits to 9 organizations
I20200220001982 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163547290 Reassigns benefits to 1 organization
I20200708001605 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163547290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

850 W Central Texas Expy
Seton Medical Center Harker Heights
Harker Heights, TX 76548-1890
Phone (254) 690-0900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
816543TXMDCertified Registered Nurse Anesthetist
AP121712TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso ASC LP CurrentSince Apr 13, 2018 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Oct 26, 2021 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Apr 2, 2013 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2019 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Nurse Anesthetist, Certified Registered CurrentSince Oct 7, 2024 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Oct 26, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Anesthesia Care Group PC CurrentSince May 15, 2020 Accepting new patients
El Paso ASC LP Nurse Anesthetist, Certified Registered CurrentSince Apr 13, 2018 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Apr 2, 2013 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2021 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients
Anesthesia Associates of El Paso PA CurrentSince Jul 1, 2014 Accepting new patients
Professional Gastroenterology & Nutrition Associates, P.a. Past Accepting new patients
Waterman Anesthesiology Group PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 27)

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185

1300 Murchison Dr
Ste 180
El Paso, TX 79902
Phone (915) 544-5000

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

Interoperability endpoints

  • Direct secure messaging: sbruckler1095363@direct.sw.org

Organizations & group practices 17

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.

View all 17

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1710208624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765081248",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Rollins St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-667-0444 x141",
            "fax_number": "407-667-4338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUCKLER",
        "first_name": "STACEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "082374-23",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9162361",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP121712",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "816543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbruckler1095363@direct.sw.org",
            "affiliation": "N",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765081248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "LESKY",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.