MARY JANE HANCOCK (CRNP) – Acute Care Nurse Practitioner, NPI 1417028903
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MARY JANE HANCOCK (CRNP)
PO BOX 40480
MOBILE, AL 366400480
Phone: (251) 470-5890
Fax: (251) 471-7925
Type: Mailing
2451, Fillingim Street, Crichton, Mobile, Mobile County, Alabama, 36617, United States
MASTIN 102
MOBILE, AL 366172238
Phone: (251) 470-5890
Fax: (251) 471-7925
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2007-01-29
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 |
|---|---|---|---|---|
| I20070129000169 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36640)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | AL | 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 45 | 30 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology) | FL | |
| Physician Assistant | AL | |
| - | AL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | AL | |
| Cardiac Surgery, Vascular Surgery | GA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | AL | |
| R H E U M A T O L O G Y | AL | |
| - | AL | |
| - | AL | |
| - | FL |
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