JACQUELINE LYNETTE DE LA GARZA (FNP-C) – Family Nurse Practitioner, NPI 1063111391
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
887 NURSE PRACTITIONER in HI
Provider Addresses for JACQUELINE LYNETTE DE LA GARZA (FNP-C)
GENERAL DELIVERY
VOLCANO, HI 967859999
Phone: (808) 430-0654
Type: Mailing
67-1123 MAMALAHOA HWY STE 120124
KAMUELA, HI 967438451
Phone: (808) 881-4710
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $414.
Total Amount is formed as General ($414) + Research ($0) + Ownership ($0) = $414.
Last reported payment date: 2024-08-09 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($121).
Total Amount
$414
General + Research + Ownership
Payments
7
Total payment records
General Amount
$414
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-09
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-11-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231127000596 | I | Nurse Practitioner | HI | 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 96785)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NV | |
| Family Practice | WA | |
| Critical Care (Intensivists), Pulmonary Disease | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | HI | |
| N E U R O L O G Y | IA | |
| Internal Medicine | HI | |
| General Surgery | OR | |
| Physician Assistant | CA | |
| H E M A T O L O G Y/ O N C O L O G Y | RI | |
| Family Practice, Emergency Medicine | TN |
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