MR. JACK FACUNDUS (ARNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1376092809
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for MR. JACK FACUNDUS (ARNP)
651 W WARREN AVE STE 100
LONGWOOD, FL 327504036
Phone: (321) 999-9617
Type: Location
1650 BERKSHIRE AVE
WINTER PARK, FL 327895403
Phone: (407) 760-9605
Type: Mailing
1650 Berkshire Ave
Winter Park, FL 327895403
Phone: (407) 760-9605
Type: Location
1 Medical Center Dr
Lebanon, NH 037560001
Phone: (603) 650-5000
Type: Location
919 E 2nd St
Sanford, FL 32771
Phone: (407) 875-3700
Type: Location
24 Railroad St
Keene, NH 034313744
Phone: (603) 354-5400
Type: Location
Southwest 60th Avenue, Ocala, Marion County, Florida, 34474, United States
SUITE 2
OCALA, FL 344766428
Phone: (352) 854-5530
Fax: (352) 854-5532
Type: Mailing
5151 ADANSON ST
ORLANDO, FL 328041317
Phone: (407) 875-3700
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $1,829.
Total Amount is formed as General ($1,829) + Research ($0) + Ownership ($0) = $1,829.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($236).
Total Amount
$1,829
General + Research + Ownership
Payments
17
Total payment records
General Amount
$1,829
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $236 |
| Teva Pharmaceuticals USA, Inc. | $202 |
| Janssen Pharmaceuticals, Inc | $140 |
| Grifols USA, LLC | $125 |
| Vanda Pharmaceuticals Inc. | $125 |
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: 2024-07-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20230515001497 | I | Nurse Practitioner | NH | TBD |
| I20240711001459 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32750)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | MT | |
| Clinical Psychologist | LA | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Certified Nurse Midwife (Cnm) | FL | |
| Clinical Social Worker | MN |
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