Dr Stacy Lauren Coulthard, MD is a medicare enrolled "Surgery" physician in Jbsa Fort Sam Houston, Texas. She went to Eastern Virginia Medical School and graduated in 2008 and has 17 years of diverse experience with area of expertise as General Surgery. She is a member of the group practice University Of Penn-medical Group and her current practice location is
Brooke Army Medical Center, 3551 Roger Brooke Drive, Jbsa Fort Sam Houston, Texas. You can reach out to her office (for appointments etc.) via phone at
(210) 916-5102.
Dr Stacy Lauren Coulthard is licensed to practice in Virginia (license number 0101246005) 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 1982864179.
Physician's Profile
| Full Name | Dr Stacy Lauren Coulthard |
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| Gender | Female |
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| Speciality | General Surgery |
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| Experience | 17 Years |
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| Location | Brooke Army Medical Center, Jbsa Fort Sam Houston, Texas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Stacy Lauren Coulthard attended and graduated from Eastern Virginia Medical School in 2008
NPI Data:
- NPI Number: 1982864179
- Provider Enumeration Date: 06/11/2008
- Last Update Date: 08/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 0941429880
- Enrollment ID: I20240919003904
Medical Identifiers
Medical identifiers for Dr Stacy Lauren Coulthard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1982864179 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 0101246005 (Virginia) | Secondary |
| 2086S0102X | Surgery - Surgical Critical Care | MD480489 (Pennsylvania) | Secondary |
| 2086S0127X | Surgery - Trauma Surgery | MD480489 (Pennsylvania) | Secondary |
| 208600000X | Surgery | 0101246005 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| University Of Penn-medical Group | 6204730955 | 3175 |
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 Stacy Lauren Coulthard allows following entities to bill medicare on her behalf.
| Entity Name | University Of Penn - Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235527342
PECOS PAC ID: 6204730955
Enrollment ID: O20141111000091 |
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| Entity Name | University Of Penn - Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053447151
PECOS PAC ID: 6204730955
Enrollment ID: O20150304001436 |
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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 Stacy Lauren Coulthard 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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Dr Stacy Lauren Coulthard, MD
Brooke Army Medical Center, 3551 Roger Brooke Drive,
Jbsa Fort Sam Houston, TX 78234-4505
Ph: (210) 916-5102 | Dr Stacy Lauren Coulthard, MD
Brooke Army Medical Center, 3551 Roger Brooke Drive,
Jbsa Fort Sam Houston, TX 78234-4505
Ph: (210) 916-5102 |
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