TRENT J FACKELMAN (FNP-C) – Family Nurse Practitioner, NPI 1407466410

TRENT J FACKELMAN (FNP-C) is a healthcare provider. based in Austin, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 816398 (TX). The NPI Number for TRENT J FACKELMAN (FNP-C) is 1407466410

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
TRENT J FACKELMAN (FNP-C)
NPI
1407466410
Phone
(210) 655-9613
Address
2600 KERRI STRUG CV
Enumeration Date
4 August 2020
Last Update Date
13 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2106546000
Graduation Year
2020 (6 years ago)
PAC ID
0648664029
Group Practice PAC ID
8022033364
Professional Enrollment ID
I20220301000718
Address ID
TX782091205SA1003XLOOP301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for TRENT J FACKELMAN (FNP-C)

  • 2600 KERRI STRUG CV

    AUSTIN, TX 787482077

    Phone: (210) 655-9613

    Type: Mailing

  • 8500 VILLAGE DR STE 202

    SAN ANTONIO, TX 782175510

    Phone: (210) 957-1419

    Fax: (210) 957-1697

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-03-01

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
I20220301000718INurse PractitionerTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report201198$0
99214Established patient office or other outpatient visit, 30-39 minutes111108$0
99204New patient office or other outpatient visit, 45-59 minutes9393$0
View full utilization report →

Insurance plans in this area (ZIP 78748)

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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: 8022033364View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)TX

Reviews

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Frequently asked questions

Where can patients find TRENT J FACKELMAN (FNP-C)'s NPI?
You can confirm TRENT J FACKELMAN (FNP-C) with NPI 1407466410; it appears in the national provider directory.
Is TRENT J FACKELMAN (FNP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is TRENT J FACKELMAN (FNP-C)?
The page reflects Family Nurse Practitioner for TRENT J FACKELMAN (FNP-C). Clinical services aligned with this taxonomy classification.
Where is TRENT J FACKELMAN (FNP-C)'s primary listing?
We display Austin, Texas because that is what the record indicates for TRENT J FACKELMAN (FNP-C).
What if Austin, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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