VIVIANA CARBAJAL (FNP) – Family Nurse Practitioner, NPI 1659932028
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for VIVIANA CARBAJAL (FNP)
3258, West 111th Street, Mount Greenwood, Chicago, Lake Township, Cook County, Illinois, 60655, United States
CHICAGO, IL 606552729
Phone: (773) 629-8217
Type: Location
3258 W 111th St
Chicago, IL 606552729
Phone: (773) 629-8217
Type: Location
6430 SELMA AVE
LOS ANGELES, CA 900287311
Phone: (323) 543-4433
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-01-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190809000386 | I | Nurse Practitioner | IL | TBD |
| I20200127000196 | I | Nurse Practitioner | IN | 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 |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 72 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 65 | 63 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 59 | 59 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 44 | 44 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 41 | 41 | $0 |
Insurance plans in this area (ZIP 60655)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | TX | |
| Family Practice | IL | |
| Hospitalist, Family Practice | IL | |
| Nurse Practitioner | IL | |
| - | IL |
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