ANASTACIA P MODO (NP) – Nurse Practitioner, NPI 1831692110
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ANASTACIA P MODO (NP)
2704 HAYNESCREST DR
GRAYSON, GA 300174280
Phone: (678) 834-3828
Type: Mailing
1810 MULKEY RD
AUSTELL, GA 301061151
Phone: (678) 540-7597
Type: Location
2496 COLUMBIA DR
DECATUR, GA 300341769
Phone: (404) 534-9222
Fax: (404) 534-9063
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $171.
Total Amount is formed as General ($171) + Research ($0) + Ownership ($0) = $171.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: ABBVIE INC. ($61).
Total Amount
$171
General + Research + Ownership
Payments
9
Total payment records
General Amount
$171
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $61 |
| AstraZeneca Pharmaceuticals LP | $22 |
| Novo Nordisk Inc | $21 |
| GlaxoSmithKline, LLC. | $19 |
| Lilly USA, LLC | $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: 2020-06-03
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 |
|---|---|---|---|---|
| I20200603001946 | I | Nurse Practitioner | GA | 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 30017)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VA | |
| - | VA | |
| - | CO | |
| Nurse Practitioner | CO | |
| - | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | FL | |
| Physician Assistant | CO | |
| - | CO | |
| - | GA |
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