KOLEY CHANCE PACK – Family Medicine Physician, NPI 1255994836
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,705 FAMILY PRACTICE in TX
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Provider Addresses for KOLEY CHANCE PACK
5100, South Coulter Street, Amarillo, Randall County, Texas, 79119, United States
AMARILLO, TX 791061786
Phone: (804) 149-9559
Fax: (806) 351-3765
Type: Mailing
2001 S COULTER ST
AMARILLO, TX 791062521
Phone: (806) 318-5777
Fax: (806) 513-6926
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $126.
Total Amount is formed as General ($126) + Research ($0) + Ownership ($0) = $126.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Dexcom, Inc. ($40).
Total Amount
$126
General + Research + Ownership
Payments
8
Total payment records
General Amount
$126
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
| Company | Amount |
|---|---|
| Dexcom, Inc. | $40 |
| AstraZeneca Pharmaceuticals LP | $29 |
| GlaxoSmithKline, LLC. | $27 |
| PFIZER INC. | $16 |
| Bayer Healthcare Pharmaceuticals Inc. | $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: 2022-08-17
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 |
|---|---|---|---|---|
| I20220817001670 | I | Family Practice | TX | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 76 | 47 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 46 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 42 | 22 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 79106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| - | TX | |
| Orthopedic Surgery | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Orthopedic Surgery | OH | |
| Nurse Practitioner | TX | |
| Orthopedic Surgery | TX | |
| - | OR | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | TX |
Reviews
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