DR. LARA DIANE CHURCH (M.D.) – Family Medicine Physician, NPI 1043280449
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,723 FAMILY PRACTICE in FL
Provider Addresses for DR. LARA DIANE CHURCH (M.D.)
141 HILDEN RD STE 201
CREDENTIALING DEPARTMENT
PONTE VEDRA, FL 320818400
Phone: (904) 825-1941
Fax: (904) 829-2850
Type: Location
PO BOX 45443
SALT LAKE CITY, UT 841450443
Phone: (904) 202-1032
Fax: (904) 376-4107
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $510.
Total Amount is formed as General ($510) + Research ($0) + Ownership ($0) = $510.
Last reported payment date: 2023-08-02 • Largest payer in this snapshot: ABBVIE INC. ($160).
Total Amount
$510
General + Research + Ownership
Payments
28
Total payment records
General Amount
$510
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $160 |
| Novo Nordisk Inc | $87 |
| Astellas Pharma US Inc | $75 |
| Dynavax Technologies Corporation | $58 |
| PFIZER INC. | $44 |
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: 2023-12-01
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 |
|---|---|---|---|---|
| I20231201002393 | I | Family Practice | TX | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 348 | 231 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 129 | 129 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 57 | 52 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 49 | 46 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 42 | 42 | $0 |
Insurance plans in this area (ZIP 32081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK | |
| Physician Assistant | AK | |
| - | AK | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK | |
| - | AK | |
| Physical Therapist In Private Practice | HI | |
| Nurse Practitioner | AK |
Reviews
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