LACI RENAE ROBERTSON – Nurse Practitioner, NPI 1407449721
Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for LACI RENAE ROBERTSON
212 AIRPORT RD W
FORT PAYNE, AL 359683335
Phone: (256) 979-1250
Fax: (256) 979-1251
Type: Mailing
212 AIRPORT ROAD W
FORT PAYNE, AL 35968
Phone: (256) 979-1250
Type: Location
1403 OLD WATER WORKS RD SW
FORT PAYNE, AL 359683353
Phone: (256) 979-1250
Type: Mailing
1403 OLD WATER WORKS ROAD
FORT PAYNE, AL 359683596
Phone: (256) 979-1250
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 97 Open Payments records for all available years, with a total value of $1,453.
Total Amount is formed as General ($1,453) + Research ($0) + Ownership ($0) = $1,453.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($497).
Total Amount
$1,453
General + Research + Ownership
Payments
97
Total payment records
General Amount
$1,453
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $497 |
| Novartis Pharmaceuticals Corporation | $197 |
| SANOFI-AVENTIS U.S. LLC | $99 |
| Amgen Inc. | $98 |
| Lilly USA, LLC | $75 |
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: 2021-06-29
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 |
|---|---|---|---|---|
| I20210629000515 | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 852 | 142 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 329 | 252 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 265 | 195 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 129 | 116 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 78 | 67 | $0 |
Insurance plans in this area (ZIP 35968)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | AL | |
| Physician Assistant | TN | |
| D E R M A T O L O G Y | AL | |
| Nurse Practitioner | AL |
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