MRS. TINA BROCK FALLEN (ARNP) – Family Nurse Practitioner, NPI 1174515423
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. TINA BROCK FALLEN (ARNP)
PO BOX 25317
TAMPA, FL 336225317
Phone: (813) 286-0033
Type: Mailing
South Kings Avenue, Brandon, Hillsborough County, Florida, 33509, United States
BRANDON, FL 335116060
Phone: (813) 681-9171
Fax: (813) 681-7580
Type: Location
PO BOX 748817
ATLANTA, GA 303748817
Phone: (813) 286-0033
Fax: (813) 286-0033
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 $44.
Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.
Last reported payment date: 2024-03-21 • Largest payer in this snapshot: Astellas Pharma US Inc ($25).
Total Amount
$44
General + Research + Ownership
Payments
2
Total payment records
General Amount
$44
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $25 |
| Organon LLC | $18 |
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: 2004-06-10
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 |
|---|---|---|---|---|
| I20040610000859 | I | Nurse Practitioner | FL | 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 |
|---|---|---|---|---|
| 77063 | Screening 3d breast mammography | 21 | 21 | $0 |
| 77067 | Screening mammography | 20 | 20 | $0 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 18 | 18 | $0 |
Insurance plans in this area (ZIP 33622)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| - | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| - | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL |
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