GOMA MAYBERRY – Family Nurse Practitioner, NPI 1588101174
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,243 NURSE PRACTITIONER in FL
Provider Addresses for GOMA MAYBERRY
773 RIVERSIDE DR
ORMOND BEACH, FL 321767878
Phone: (386) 795-2457
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 49 Open Payments records for all available years, with a total value of $1,125.
Total Amount is formed as General ($1,125) + Research ($0) + Ownership ($0) = $1,125.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($362).
Total Amount
$1,125
General + Research + Ownership
Payments
49
Total payment records
General Amount
$1,125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $362 |
| AstraZeneca Pharmaceuticals LP | $202 |
| PFIZER INC. | $85 |
| Exact Sciences Corporation | $85 |
| PhotoniCare Inc | $34 |
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: 2017-03-29
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 |
|---|---|---|---|---|
| I20170329000286 | 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 | 193 | 108 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 66 | 50 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 37 | 37 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 28 | 25 | $0 |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 24 | 13 | $0 |
Insurance plans in this area (ZIP 32176)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| General Practice | PR | |
| Osteopathic Manipulative Medicine | FL | |
| Family Practice | FL |
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