KEYNA OMENUKOR – Family Nurse Practitioner, NPI 1215307715
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for KEYNA OMENUKOR
1675 REPUBLIC PKWY STE 101
MESQUITE, TX 751506902
Phone: (972) 576-7399
Fax: (972) 476-0006
Type: Mailing
1675 REPUBLIC PKWY
#101
MESQUITE, TX 751506903
Phone: (972) 576-7399
Fax: (972) 476-0006
Type: Location
1675 REPUBLIC PKWY STE 190
MESQUITE, TX 751506902
Phone: (972) 576-7399
Fax: (972) 476-0006
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $660.
Total Amount is formed as General ($660) + Research ($0) + Ownership ($0) = $660.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($405).
Total Amount
$660
General + Research + Ownership
Payments
19
Total payment records
General Amount
$660
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-10-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20160316001235 | I | Nurse Practitioner | TX | TBD |
| I20240118001617 | I | Nurse Practitioner | DC | TBD |
| I20240307002737 | I | Nurse Practitioner | WA | TBD |
| I20241029004309 | I | Nurse Practitioner | NM | 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 75150)
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