MARCENE R. MCVAY GILLAM (MD) – Pediatric Surgery Physician, NPI 1962627984
Pediatric Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
261 PEDIATRIC MEDICINE in OK
Provider Addresses for MARCENE R. MCVAY GILLAM (MD)
6151 S Yale Ave Ste 1305
Tulsa, OK 741361907
Phone: (918) 494-9450
Fax: (918) 494-9437
Type: Location
3623 Johnson Mill Blvd Ste 101
Springdale, AR 727626412
Phone: (479) 222-0190
Fax: (800) 730-1097
Type: Location
#1 CHILDREN'S WAY #653
LITTLE ROCK, AR 722023500
Phone: (501) 364-1100
Type: Mailing
1 CHILDRENS WAY # 653
LITTLE ROCK, AR 722023500
Phone: (501) 364-1100
Type: Location
PO BOX 6908
SPRINGDALE, AR 727666908
Phone: (501) 349-3182
Type: Mailing
4502 MEDICAL DR
SAN ANTONIO, TX 782294402
Phone: (210) 358-4000
Fax: (210) 358-4775
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $34.
Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.
Last reported payment date: 2024-06-24 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($19).
Total Amount
$34
General + Research + Ownership
Payments
2
Total payment records
General Amount
$34
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $19 |
| KLS-Martin L.P. | $15 |
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: 2023-12-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20130501000077 | I | Pediatric Medicine | TX | TBD |
| I20170607001556 | I | General Surgery | AR | TBD |
| I20231229000569 | I | General Surgery | OK | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74136)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| Hospitalist, Internal Medicine | TX | |
| - | TX | |
| - | TX | |
| Interventional Cardiology, Internal Medicine, Cardiovascular Disease (Cardiology) | TX | |
| A N E S T H E S I O L O G Y | TX | |
| A N E S T H E S I O L O G Y | TX | |
| Pediatric Medicine, Cardiovascular Disease (Cardiology) | TX |
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.