Dr Larissa Stacy, PT, DPT is a medicare enrolled "Physical Therapist" provider in Kermit, West Virginia. Her current practice location is
47454 Route 52, Kermit, West Virginia. You can reach out to her office (for appointments etc.) via phone at
(304) 393-4072.
Dr Larissa Stacy is licensed to practice in West Virginia (license number CP004549T) 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 1811411887.
Healthcare Provider's Profile
Full Name | Dr Larissa Stacy |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 47454 Route 52, Kermit, West Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1811411887
- Provider Enumeration Date: 08/01/2017
- Last Update Date: 10/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 0446627210
- Enrollment ID: I20221108000892
Medical Identifiers
Medical identifiers for Dr Larissa Stacy such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811411887 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 007169 (Kentucky) | Secondary |
225100000X | Physical Therapist | CP004549T (West Virginia) | 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. Dr Larissa Stacy allows following entities to bill medicare on her behalf.
Provider Name | Summit Physical Therapy Limited Partnership |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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Provider Identifiers | NPI Number: 1336878263 PECOS PAC ID: 9830574391 Enrollment ID: O20221101000135 |
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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. Dr Larissa 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 Address | Practice Location Address |
Dr Larissa Stacy, PT, DPT 414 Penco Rd, Weirton, WV 26062-3822 Ph: (304) 393-4072 | Dr Larissa Stacy, PT, DPT 47454 Route 52, Kermit, WV 25674-8052 Ph: (304) 393-4072 |
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