SIMON MUTTANIL JR. CHACKO (ARNP) – Nurse Practitioner, NPI 1477782860
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for SIMON MUTTANIL JR. CHACKO (ARNP)
14030 BISCAYNE BLVD
APT. 210
NORTH MIAMI BEACH, FL 331811535
Phone: (516) 761-0935
Type: Mailing
PO BOX 7410884
CHICAGO, IL 606740884
Phone: (702) 899-0595
Fax: (702) 977-1496
Type: Mailing
3117 W GANDY BLVD
TAMPA, FL 336112927
Phone: (872) 231-3162
Fax: (702) 977-1496
Type: Location
646, Seneca Street, Larkinville, Buffalo, Erie County, New York, 14210, United States
BUFFALO, NY 142101351
Phone: (716) 995-4450
Type: Location
519A E BLOOMINGDALE AVE STE A
BRANDON, FL 335118105
Phone: (813) 655-4100
Fax: (813) 655-1775
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: Insmed, Inc. ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Insmed, Inc. | $17 |
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: 2017-03-03
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 |
|---|---|---|---|---|
| I20170303000864 | 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 |
|---|---|---|---|---|
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 1,330 | 67 | $0 |
| 96521 | Refilling and maintenance of portable pump | 1,330 | 67 | $0 |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 1,330 | 67 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,104 | 67 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 209 | 42 | $0 |
Insurance plans in this area (ZIP 33181)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | IL | |
| Physical Medicine And Rehabilitation | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Physical Medicine And Rehabilitation | FL |
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