Staci Gottlieb, RN, MSN, PMHNP in Fort Worth, TX

Staci Gottlieb, RN, MSN, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fort Worth, Texas. She graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Helen Farabee Centers and her current practice location is 901 7th Ave, Suite 230, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (682) 885-1050.

Staci Gottlieb is licensed to practice in Texas (license number 741675) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1699052555.

Contact Information

	Staci Gottlieb, RN, MSN, PMHNP
	901 7th Ave, Suite 230, Fort Worth, TX 76104-2722
	(682) 885-1050
	(682) 885-7572

Map and Direction

Provider's Profile

Full Name	Staci Gottlieb
Gender	Female
Speciality	Nurse Practitioner
Experience	13 Years
Location	901 7th Ave, Fort Worth, Texas
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Staci Gottlieb graduated from nursing school in 2011

NPI Data:

NPI Number: 1699052555
Provider Enumeration Date: 11/07/2011
Last Update Date: 07/29/2016

Medicare PECOS Information:

PECOS PAC ID: 6800057662
Enrollment ID: I20120423000364

Medical Identifiers

Medical identifiers for Staci Gottlieb such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699052555	NPI	-	NPPES
293955505	Medicaid	TX
293955504	Medicaid	TX
8600NA	Other	TX	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	741675 (Texas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Helen Farabee Centers	8729042916	12

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. Staci Gottlieb allows following entities to bill medicare on her behalf.

Entity Name	My Health My Resources Of Tarrant County
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952423782 PECOS PAC ID: 6406755693 Enrollment ID: O20040107000397

Entity Name	Cook Childrens Physician Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750369203 PECOS PAC ID: 7719884584 Enrollment ID: O20040128000800

Entity Name	Helen Farabee Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457479511 PECOS PAC ID: 8729042916 Enrollment ID: O20041117000552

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. Staci Gottlieb 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
Staci Gottlieb, RN, MSN, PMHNP Po Box 99371, Fort Worth, TX 76199-0371 Ph: (682) 885-1855	Staci Gottlieb, RN, MSN, PMHNP 901 7th Ave, Suite 230, Fort Worth, TX 76104-2722 Ph: (682) 885-1050

Reviews and Comments

Nurse Practitioner Nurses in Fort Worth, TX

Mrs. Amy Michelle Medalie, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4405 River Oaks Blvd, Fort Worth, TX 76114 Phone: 817-624-1770 Fax: 817-625-1287
Valerie Elise Ward, RN, CPNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2755 Miller Ave, Fort Worth, TX 76105 Phone: 817-534-7110 Fax: 817-413-0521
Maria Sybil Gagliano, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6000 Bryant Irvin Rd, Fort Worth, TX 76132 Phone: 866-389-2727
Kristi E Tucker, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 801 7th Ave, Fort Worth, TX 76104 Phone: 682-885-1475 Fax: 682-885-7520
Lacy Pitchford, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1263 W Rosedale St Ste 200, Fort Worth, TX 76104 Phone: 817-336-4896 Fax: 817-332-2805
Mary Agnes Johnson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1400 8th Ave, Fort Worth, TX 76104 Phone: 817-922-7070
Susan Akberzie, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1401 W Pulaski St, Fort Worth, TX 76104 Phone: 682-885-8012 Fax: 682-885-8014

Staci Gottlieb, RN, MSN, PMHNP - Medicare Nurse Practitioner in Fort Worth, TX