Individual provider Active NPI

Adam D Sterlace, DO

  • General Practice Physician
  • Pecos, TX
National Provider Identifier
1811033863
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
P1495 Issued in TX
Practice address
98 W County Road 204
Reeves County Detention Center III - Medical
Pecos, TX 79772-7208
Phone
(432) 447-2909
Fax
(432) 447-2896
NPI assigned
Jan 29, 2007
Last updated
Mar 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X P1495 TX Primary

Addresses

Primary practice location

98 W County Road 204
Reeves County Detention Center III - Medical
Pecos, TX 79772-7208

Mailing address

98 W County Road 204
Reeves County Detention Center III - Medical
Pecos, TX 79772-7208
Phone (432) 447-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231003000504 FL Practitioner - General Practice 8820256340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Nova Southeastern College of Osteo Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2011 S 25TH St
Suite 206
Fort Pierce, FL 34947-4795
Phone (772) 237-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P1495TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tcmmd LLC CurrentSince Oct 15, 2024 Accepting new patients
Primary Care Solutions & More LLC CurrentSince Sep 19, 2023 Accepting new patients

Locations

2011 S 25th St
Ste 206
Fort Pierce, FL 34947
Phone (772) 237-3600

1701 SE Hillmoor Dr
Ste 7
Port St Lucie, FL 34952
Phone (772) 398-9808

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1811033863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 W COUNTY ROAD 204",
            "address_2": "REEVES COUNTY DETENTION CENTER III - MEDICAL",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797727208",
            "telephone_number": "432-447-2909",
            "fax_number": "432-447-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 W COUNTY ROAD 204",
            "address_2": "REEVES COUNTY DETENTION CENTER III - MEDICAL",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797727208",
            "telephone_number": "432-447-2909",
            "fax_number": "432-447-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERLACE",
        "first_name": "ADAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "P1495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pecos, TX

Sources for this page

Verify at the official NPI Registry.