Dr Stanislav Nickolaevich Tolkachjov, MD is a medicare enrolled "Dermatology" physician in Lewisville, Texas. He went to University Of Tennessee, Hsc, College Of Medicine and graduated in 2012 and has 13 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Epiphany Dermatology Pa and his current practice location is
1640 Fm 544 Ste 100, Lewisville, Texas. You can reach out to his office (for appointments etc.) via phone at
(972) 395-1101.
Dr Stanislav Nickolaevich Tolkachjov is licensed to practice in Texas (license number R9876) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1952662868.
Physician's Profile
| Full Name | Dr Stanislav Nickolaevich Tolkachjov |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 13 Years |
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| Location | 1640 Fm 544 Ste 100, Lewisville, Texas |
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| Accepts Medicare Assignments | Yes. He 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 Stanislav Nickolaevich Tolkachjov attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 2012
NPI Data:
- NPI Number: 1952662868
- Provider Enumeration Date: 06/06/2012
- Last Update Date: 09/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 4284870809
- Enrollment ID: I20190221000835
Medical Identifiers
Medical identifiers for Dr Stanislav Nickolaevich Tolkachjov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1952662868 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | R9876 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Epiphany Dermatology Pa | 3971827791 | 77 |
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 Stanislav Nickolaevich Tolkachjov allows following entities to bill medicare on his behalf.
| Entity Name | Epiphany Dermatology Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043615263
PECOS PAC ID: 3971827791
Enrollment ID: O20150126001498 |
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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 Stanislav Nickolaevich Tolkachjov 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 Stanislav Nickolaevich Tolkachjov, MD
7300 Ranch Road 2222, Bldg 1, Ste 200,
Austin, TX 78730-3255
Ph: (512) 628-0465 | Dr Stanislav Nickolaevich Tolkachjov, MD
1640 Fm 544 Ste 100,
Lewisville, TX 75056-7013
Ph: (972) 395-1101 |
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