MRS. CARISSA PETERSON (ARNP) – Adult Health Nurse Practitioner, NPI 1376097105
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
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Provider Addresses for MRS. CARISSA PETERSON (ARNP)
West Indian River Boulevard, Edgewater, Volusia County, Florida, 32132, United States
STE 2&3
EDGEWATER, FL 321323591
Phone: (386) 663-3003
Type: Location
109 W KNAPP AVE
EDGEWATER, FL 321321555
Phone: (386) 957-4100
Fax: (386) 957-4104
Type: Location
472, Old Mission Road, New Smyrna Beach, Volusia County, Florida, 32168, United States
NEW SMYRNA BEACH, FL 321688552
Phone: (386) 314-7483
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $483.
Total Amount is formed as General ($483) + Research ($0) + Ownership ($0) = $483.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($143).
Total Amount
$483
General + Research + Ownership
Payments
23
Total payment records
General Amount
$483
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $143 |
| ITI, Inc. | $66 |
| Novo Nordisk Inc | $66 |
| Amgen Inc. | $51 |
| Exact Sciences Corporation | $27 |
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: 2019-08-19
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 |
|---|---|---|---|---|
| I20190819000443 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 32 | 26 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 29 | 22 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 27 | 27 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 32132)
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