Madisen Tayler Stacks, is a medicare enrolled "Nurse Practitioner - Family" in Lake Dallas, Texas. Her current practice location is
503 Main St Ste C, Lake Dallas, Texas. You can reach out to her office (for appointments etc.) via phone at
(940) 535-5296.
Madisen Tayler Stacks is licensed to practice in Texas (license number 1029434) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063004158.
Provider's Profile
| Full Name | Madisen Tayler Stacks |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 503 Main St Ste C, Lake Dallas, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063004158
- Provider Enumeration Date: 02/09/2021
- Last Update Date: 08/24/2021
Medicare PECOS Information:
- PECOS PAC ID: 1456757384
- Enrollment ID: I20210901001351
Medical Identifiers
Medical identifiers for Madisen Tayler Stacks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063004158 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 1029434 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Madisen Tayler Stacks allows following entities to bill medicare on her behalf.
| Entity Name | Lake Dallas Family Medicine Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871158907
PECOS PAC ID: 3274863394
Enrollment ID: O20191002001957 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Madisen Tayler Stacks is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Madisen Tayler Stacks,
503 Main St Ste C,
Lake Dallas, TX 75065-2878
Ph: (832) 367-8843 | Madisen Tayler Stacks,
503 Main St Ste C,
Lake Dallas, TX 75065-2878
Ph: (940) 535-5296 |
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