HAVEN SHAYE BROLSMA (CRNP) – Family Nurse Practitioner, NPI 1316541287
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for HAVEN SHAYE BROLSMA (CRNP)
1908 Cherokee Ave SW
Cullman, AL 350555502
Phone: (256) 736-1460
Type: Location
101 IVORY PL
MADISON, AL 357582349
Phone: (256) 325-0236
Type: Location
2926 COUNTY ROAD 143
BREMEN, AL 350337031
Phone: (256) 590-1502
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $144.
Total Amount is formed as General ($144) + Research ($0) + Ownership ($0) = $144.
Last reported payment date: 2024-07-17 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($125).
Total Amount
$144
General + Research + Ownership
Payments
2
Total payment records
General Amount
$144
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $125 |
| AstraZeneca Pharmaceuticals LP | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210311000489 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 472 | 92 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 283 | 65 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 175 | 80 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 161 | 122 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 142 | 113 | $0 |
Insurance plans in this area (ZIP 35055)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| - | AL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | AL | |
| Internal Medicine | AL | |
| Nurse Practitioner | AL | |
| Physician Assistant | AL |
Reviews
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