Pamela Renee Stacy, ACNP - Medicare Nurse Practitioner in Tyler, TX

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Pamela Renee Stacy, ACNP is a medicare enrolled "Nurse Practitioner - Family" in Tyler, Texas. Her current practice location is 8288 S Broadway Ave, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 606-7060.

Pamela Renee Stacy is licensed to practice in Texas (license number AP121213) 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 1821367327.

Contact Information

Pamela Renee Stacy, ACNP
8288 S Broadway Ave,
Tyler, TX 75703-5262
(903) 606-7060
Not Available

Map and Direction




Provider's Profile

Full NamePamela Renee Stacy
GenderFemale
SpecialityNurse Practitioner - Family
Location8288 S Broadway Ave, Tyler, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1821367327
  • Provider Enumeration Date: 12/29/2011
  • Last Update Date: 10/28/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7113186297
  • Enrollment ID: I20120308000698

Medical Identifiers

Medical identifiers for Pamela Renee Stacy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821367327NPI-NPPES
75-2616977-118OtherTXTRICARE
293825001MedicaidTX
75-2616977-007OtherTXTRICARE
867N10OtherTXBCBS
75-2616977-066OtherTXTRICARE
752616977042OtherTXTRICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner AP121213 (Texas)Secondary
363LA2100XNurse Practitioner - Acute Care AP121213 (Texas)Secondary
363LA2100XNurse Practitioner - Acute Care 729458 (Texas)Secondary
363LF0000XNurse Practitioner - Family AP121213 (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. Pamela Renee Stacy allows following entities to bill medicare on her behalf.
Entity NameChristus Trinity Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091
Entity NameMother Frances Hospital Jacksonville
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952306672
PECOS PAC ID: 5597751024
Enrollment ID: O20040421001092
Entity NameMother Frances Hospital Regional Health Care Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679578439
PECOS PAC ID: 9234025636
Enrollment ID: O20040610001042

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. Pamela Renee Stacy 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 AddressPractice Location Address
Pamela Renee Stacy, ACNP
Po Box 846098,
Dallas, TX 75284-6098

Ph: (903) 324-6450		Pamela Renee Stacy, ACNP
8288 S Broadway Ave,
Tyler, TX 75703-5262

Ph: (903) 606-7060

Reviews and Comments


Nurse Practitioner Nurses in Tyler, TX

Brandi Dunford, FNP-C
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Abram Ambriz, NP
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Anna Elise Fenton, NP
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Mary Anne Fitzgerald, NP
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Rendall Northcutt, FNP
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Kinsey Henry, MSN, APRN, FNP-C
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Practice Location: 1720 S Beckham Ave, Tyler, TX 75701
Phone: 903-630-6211    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.