Lacy R Stark, PA

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP135511 Issued in TX

Practice address

1307 8TH Ave
Suite 608
Fort Worth, TX 76104-4140

Phone

(817) 921-4191

Fax

(817) 429-7783

NPI assigned

Oct 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Neuroscience PAGroup PAC ID 5991737926, 3 clinicians

Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Baylor Institute for Rehabilitation at Fort Worth Inpatient rehabilitation facility, Fort Worth, TX, CCN 673035

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9382/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/JJJIAA
• Direct secure messaging: lacy.stark.1@9382.direct.athenahealth.com

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.

• Clinical Neuroscience PA

  • Neurology Physician
  • Fort Worth, TX
  • NPI 1760459671
  Medicare reassignment Care Compare group NPD
• Tarrant Neurology Consultants, P.a.

  • Neurology Physician
  • Fort Worth, TX
  • NPI 1740509843
  NPD (past)
• Vinit Mehrotra, MD, PA

  • Neurological Surgery Physician
  • Fort Worth, TX
  • NPI 1861504136
  NPD (past)

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

• Global Rehab Fort Worth, LP

  • Rehabilitation Hospital
  • Fort Worth, TX
  • NPI 1396902540

  Inpatient rehabilitation facility

  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1922510205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "SUITE 608",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044140",
            "telephone_number": "817-921-4191",
            "fax_number": "817-429-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "SUITE 608",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044140",
            "telephone_number": "817-921-4191",
            "fax_number": "817-429-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "LACY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2024-04-29",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP135511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Richard Stapley
• Star Diagnostics of Tarrant County
• Star Formula Inc
• Star Neuro Monitoring LLC
• Star Retina PLLC
• Karis Starke
• Kelly C Starkey, M.D.
• Katie Nicole Finnerty Starks, M.D., M.S.
• Raechelle Starks
• Tiffanie Starks, RN

• Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.