MALLORY B HOMMERTZHEIM (NP) – Family Nurse Practitioner, NPI 1073154787
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,198 NURSE PRACTITIONER in CO
Provider Addresses for MALLORY B HOMMERTZHEIM (NP)
2417 NW 174TH ST
EDMOND, OK 730127108
Phone: (405) 255-6706
Type: Mailing
7610 N Union Blvd Ste 150
Colorado Springs, CO 809203800
Phone: (719) 434-8810
Fax: (519) 805-2164
Type: Location
7610 N UNION BLVD STE 150
COLORADO SPRINGS, CO 809203800
Phone: (719) 434-8810
Fax: (519) 805-2164
Type: Mailing
595 CHAPEL HILLS DR STE 303B
COLORADO SPRINGS, CO 809201022
Phone: (719) 922-1002
Fax: (719) 888-1841
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-12-05 • Largest payer in this snapshot: Axonics, Inc. ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $19 |
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: 2021-03-22
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 |
|---|---|---|---|---|
| I20210322002500 | I | Nurse Practitioner | CO | 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 |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 768 | 111 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 272 | 85 | $0 |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 40 | 27 | $0 |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 37 | 37 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 35 | 15 | $0 |
Insurance plans in this area (ZIP 73012)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Medicine And Rehabilitation | CO | |
| Physician Assistant | GA | |
| Family Practice | GA | |
| Nurse Practitioner | CO | |
| Nurse Practitioner | WA | |
| Physician Assistant | CO | |
| Nurse Practitioner | SD | |
| Physician Assistant | CO | |
| Physician Assistant | AL | |
| Nurse Practitioner | CO |
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.