DECLAN FOTOH (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063258341

DECLAN FOTOH (PMHNP) is a healthcare provider. based in Lowell, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 2024058381 (MA). The NPI Number for DECLAN FOTOH (PMHNP) is 1063258341

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DECLAN FOTOH (PMHNP)
NPI
1063258341
Phone
Not provided
Address
600 PINE ST
Enumeration Date
5 July 2024
Last Update Date
5 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7182984375
Graduation Year
2024 (2 years ago)
PAC ID
9638608813
Group Practice PAC ID
8628346731
Professional Enrollment ID
I20250203001494
Address ID
MA021084209BO44XXXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

Provider Addresses for DECLAN FOTOH (PMHNP)

  • 600 PINE ST

    LOWELL, MA 018512309

    Phone:

    Mailing address matches the actual address.

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: 2025-02-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250203001494INurse PractitionerMATBD

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.

Verify on CMS Revalidation Lookup Tool

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 01851)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628346731View full group profile
NameSpecialtyState
Nurse PractitionerMA
Nurse PractitionerVT
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Clinical Social WorkerMA
Nurse PractitionerMA
Nurse PractitionerMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

What is the registry number for DECLAN FOTOH (PMHNP)?
The registry entry for DECLAN FOTOH (PMHNP) shows NPI 1063258341.
Is DECLAN FOTOH (PMHNP) currently accepting referrals based on NPI status?
Registry metadata lists DECLAN FOTOH (PMHNP) as active.
How should patients interpret DECLAN FOTOH (PMHNP)'s specialty?
The extract shows Psychiatric/Mental Health Nurse Practitioner for DECLAN FOTOH (PMHNP). Clinical services aligned with this taxonomy classification.
Can patients visit DECLAN FOTOH (PMHNP) in Lowell, Massachusetts?
For routing, start with Lowell, Massachusetts for DECLAN FOTOH (PMHNP), then verify phone and hours locally.
Who maintains DECLAN FOTOH (PMHNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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