JODY LEE MORENO – Nurse Practitioner, NPI 1508212796
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 JODY LEE MORENO
3991 BRUTON RD
PLANT CITY, FL 335657023
Phone: (813) 716-9698
Type: Mailing
460, Via el Chico, Hollywood Riviera, Redondo Beach, Los Angeles County, California, 90277, United States
HOLLYWOOD, FL 330216933
Phone: (954) 923-7440
Fax: (866) 968-6339
Type: Location
455 Emerald Ave
Lake Wales, FL 338534716
Phone: (863) 697-1472
Type: Location
3440 Hollywood Blvd Ste 460
Hollywood, FL 330216933
Phone: (954) 923-7440
Fax: (866) 968-6339
Type: Location
1324 Lakeland Hills Blvd
Lakeland, FL 338054543
Phone: (863) 687-1100
Type: Location
3525 LAKELAND HILLS BLVD
LAKELAND, FL 338051965
Phone: (863) 603-6565
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2016-10-19
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 |
|---|---|---|---|---|
| I20161019001544 | 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 33565)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | TX | |
| - | FL | |
| - | FL | |
| Physical Medicine And Rehabilitation | MD | |
| Nurse Practitioner | FL | |
| - | FL | |
| Thoracic Surgery | OH | |
| Nurse Practitioner | FL | |
| Family Practice | FL |
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