MYRNA GACUSAN – Family Nurse Practitioner, NPI 1174976088

MYRNA GACUSAN is a healthcare provider. based in Duluth, Georgia. specializing in Family Nurse Practitioner. They hold a License No. 151283 (GA). The NPI Number for MYRNA GACUSAN is 1174976088

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MYRNA GACUSAN
NPI
1174976088
Phone
Not provided
Address
4395 ABBOTTS POINTE CT
Enumeration Date
14 July 2016
Last Update Date
14 July 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8887720076
Graduation Year
2015 (11 years ago)
PAC ID
1658620489
Group Practice PAC ID
4486895083
Professional Enrollment ID
I20180827003660
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for MYRNA GACUSAN

  • 4395 ABBOTTS POINTE CT

    DULUTH, GA 300972199

    Phone:

    Type: Mailing

  • 6911 TARA BLVD

    JONESBORO, GA 302361503

    Phone: (770) 477-8573

    Fax: (770) 477-8573

    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 $111.

Total Amount is formed as General ($111) + Research ($0) + Ownership ($0) = $111.

Last reported payment date: 2023-06-27 • Largest payer in this snapshot: Melinta Therapeutics, LLC ($111).

Total Amount

$111

General + Research + Ownership

Payments

1

Total payment records

General Amount

$111

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Melinta Therapeutics, LLC$111
View all Open Payments →|Open Payments Risk Radar →

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: 2018-08-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180827003660INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30097)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486895083View full group profile

Reviews

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No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is there an official ID for MYRNA GACUSAN in U.S. healthcare records?
The official identifier for MYRNA GACUSAN is NPI 1174976088.
Is MYRNA GACUSAN still an active registrant?
MYRNA GACUSAN carries an active NPI according to the public dataset.
What kind of doctor is MYRNA GACUSAN?
MYRNA GACUSAN is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is MYRNA GACUSAN located near Duluth?
MYRNA GACUSAN currently maps to Duluth, Georgia in this extract.
Does MYRNA GACUSAN accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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