MISTY KAY FORTNER (PA-C) – Physician Assistant, NPI 1609152776
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for MISTY KAY FORTNER (PA-C)
5424 19th St Ste 300
Lubbock, TX 794072164
Phone: (806) 795-4391
Fax: (806) 796-1354
Type: Location
5000 Briarwood Ave
Midland, TX 797072753
Phone: (432) 682-5385
Fax: (432) 682-1265
Type: Location
5000 BRIARWOOD AVE
MIDLAND, TX 797072753
Phone: (432) 682-5385
Fax: (432) 682-1265
Type: Location
5220 80TH ST
LUBBOCK, TX 794242862
Phone: (806) 771-2400
Fax: (806) 771-7760
Type: Mailing
5424 19TH ST STE 300
LUBBOCK, TX 794072164
Phone: (806) 795-4391
Fax: (806) 796-1354
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $928.
Total Amount is formed as General ($928) + Research ($0) + Ownership ($0) = $928.
Last reported payment date: 2023-08-03 • Largest payer in this snapshot: GENZYME CORPORATION ($195).
Total Amount
$928
General + Research + Ownership
Payments
48
Total payment records
General Amount
$928
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-03
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: 2025-07-09
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 |
|---|---|---|---|---|
| I20250709000485 | I | Physician Assistant | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79407)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| R H E U M A T O L O G Y | TX | |
| R H E U M A T O L O G Y | TX | |
| R H E U M A T O L O G Y | TX |
Reviews
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