JACKIE R GYOMORY (ACNP-BC) – Acute Care Nurse Practitioner, NPI 1699075044
Acute Care Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for JACKIE R GYOMORY (ACNP-BC)
5841 S MARYLAND AVE
MC 5028
CHICAGO, IL 606371447
Phone: (773) 702-8344
Fax: (773) 702-0863
Type: Mailing
3601 W 13 MILE RD
ROYAL OAK, MI 480736712
Phone: (248) 898-5000
Type: Location
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 480333849
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $794.
Total Amount is formed as General ($794) + Research ($0) + Ownership ($0) = $794.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Kerecis Limited ($224).
Total Amount
$794
General + Research + Ownership
Payments
24
Total payment records
General Amount
$794
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $224 |
| Integra LifeSciences Corporation | $91 |
| Boston Scientific Corporation | $68 |
| CARDIVA MEDICAL, INC. | $62 |
| Hydrofera LLC | $46 |
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: 2018-01-17
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 |
|---|---|---|---|---|
| I20180117001699 | I | Nurse Practitioner | MI | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 97 | 91 | $0 |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 32 | 11 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 26 | 26 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 23 | 18 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 16 | 12 | $0 |
Insurance plans in this area (ZIP 60637)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Vascular Surgery | MI | |
| General Surgery, Vascular Surgery, Critical Care (Intensivists) | MI | |
| Vascular Surgery | MI | |
| Vascular Surgery | MI | |
| Vascular Surgery | PA |
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