Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane M Tackitt, DO

Individual provider Hospitalist Physician · NPI 1588035976

Dr. Shane M Tackitt, DO is an Internal Medicine in Mansfield, Texas. Qualified in 2017, 9 years ago. Practices with Lonestar Hospital Medicine Associates PA, a 124-clinician group and accepts Medicare assignment. Licensed in Texas and Washington.

Years since qualifying
9
Licensed in
TX, WA
In the registry since
2015
Specialties on file
5
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2700 E Broad St
Mansfield, TX 76063-5899
Phone: (682) 242-6470
Fax: (682) 622-2092
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence S5274 (TX)
Hospitalist Physician Taxonomy 208M00000X · Licence S5274 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence BP10058725 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence S5274 (TX)

Record details

NPI number1588035976
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedOctober 12, 2015
Last updated in NPPESJuly 1, 2020
Certification dateJuly 1, 2020
Mailing address2700 E Broad St, Department Internal Medicine, Mansfield, TX 76063-5899

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Lonestar Hospital Medicine Associates Pa — 124 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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