MRS. MARY GRACE DIFUNTORUM (APRN, FNP) – Family Nurse Practitioner, NPI 1659078129

MRS. MARY GRACE DIFUNTORUM (APRN, FNP) is a healthcare provider. based in Mustang, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, FNP. They hold a License No. 210920 (OK). The NPI Number for MRS. MARY GRACE DIFUNTORUM (APRN, FNP) is 1659078129

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY GRACE DIFUNTORUM (APRN, FNP)
NPI
1659078129
Phone
(405) 730-6990
Address
160 E SW 59th St
Enumeration Date
14 February 2023
Last Update Date
20 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4057306990
Graduation Year
2022 (4 years ago)
PAC ID
6305372681
Group Practice PAC ID
3870922008
Professional Enrollment ID
I20241210002877
Address ID
OK731605833MO400XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for MRS. MARY GRACE DIFUNTORUM (APRN, FNP)

  • 160 E SW 59th St

    Mustang, OK 730644722

    Phone: (405) 730-6990

    Fax: (405) 730-6992

    Type: Location

  • PO BOX 891625

    OKLAHOMA CITY, OK 731891625

    Phone:

    Type: Mailing

  • 400 N EASTERN AVE

    MOORE, OK 731605833

    Phone: (405) 730-6990

    Fax: (405) 730-6992

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $101.

Total Amount is formed as General ($101) + Research ($0) + Ownership ($0) = $101.

Last reported payment date: 2024-01-11 • Largest payer in this snapshot: ABIOMED ($101).

Total Amount

$101

General + Research + Ownership

Payments

1

Total payment records

General Amount

$101

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABIOMED$101
View all Open Payments →|Open Payments Risk Radar →

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: 2024-12-10

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
I20241210002877INurse PractitionerOKTBD

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 73064)

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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: 3870922008View full group profile
NameSpecialtyState
-OK
Nurse PractitionerOK
Nurse PractitionerOK
Physician AssistantOK
-OK
Family Practice, Pediatric MedicineOK

Reviews

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Frequently asked questions

What federal number belongs to MRS. MARY GRACE DIFUNTORUM (APRN, FNP)?
The federal identifier for MRS. MARY GRACE DIFUNTORUM (APRN, FNP) is NPI 1659078129.
Is MRS. MARY GRACE DIFUNTORUM (APRN, FNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MRS. MARY GRACE DIFUNTORUM (APRN, FNP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for MRS. MARY GRACE DIFUNTORUM (APRN, FNP). Clinical services aligned with this taxonomy classification.
Does MRS. MARY GRACE DIFUNTORUM (APRN, FNP) practice in Oklahoma?
You will see Mustang, Oklahoma on file for MRS. MARY GRACE DIFUNTORUM (APRN, FNP) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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