MACEY PURDOM (APN) – Nurse Practitioner, NPI 1063183929
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MACEY PURDOM (APN)
PO BOX 713260
CHICAGO, IL 606770001
Phone: (630) 469-9200
Type: Mailing
303 W OGDEN AVE
WESTMONT, IL 605591419
Phone: (630) 435-6107
Fax: (630) 328-2375
Type: Location
4371 WESTDALE DR
FORT WORTH, TX 761094931
Phone: (210) 380-3080
Type: Mailing
12890 Hillcrest Rd Ste 203
Dallas, TX 752306562
Phone: (972) 239-2777
Type: Location
630 W Wheatland Rd
Duncanville, TX 751164518
Phone: (972) 239-2777
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $1,059.
Total Amount is formed as General ($1,059) + Research ($0) + Ownership ($0) = $1,059.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Astellas Pharma US Inc ($312).
Total Amount
$1,059
General + Research + Ownership
Payments
48
Total payment records
General Amount
$1,059
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $312 |
| Sumitomo Pharma America, Inc. | $170 |
| MAYNE PHARMA COMMERCIAL LLC | $124 |
| Exeltis, USA Inc. | $77 |
| ABBVIE INC. | $61 |
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: 2023-04-18
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 |
|---|---|---|---|---|
| I20230418001704 | I | Nurse Practitioner | IL | 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 60677)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| E N D O C R I N O L O G Y | IL | |
| Physician Assistant | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physical Therapist In Private Practice | IL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.