Dr Larissa Stacy, PT, DPT is a medicare enrolled "Physical Therapist" provider in Kermit, West Virginia. She graduated from medical school in 2017 and has 8 years of diverse experience with area of expertise as Physical Therapist In Private Practice. She is a member of the group practice Summit Physical Therapy Limited Partnership and 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
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 1811411887.
Healthcare Provider's Profile
| Full Name | Dr Larissa Stacy |
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| Gender | Female |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 8 Years |
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| Location | 47454 Route 52, Kermit, West Virginia |
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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 Larissa Stacy graduated from medical school in 2017
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 |
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| 225100000X | Physical Therapist | 007169 (Kentucky) | Secondary |
| 225100000X | Physical Therapist | CP004549T (West Virginia) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Summit Physical Therapy Limited Partnership | 9830574391 | 11 |
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 |
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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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