SHMYRA FOUNTAIN (FNP-BC) – Nurse Practitioner, NPI 1609652262
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
887 NURSE PRACTITIONER in HI
Provider Addresses for SHMYRA FOUNTAIN (FNP-BC)
1301 SOLANA BLVD STE 2200
WESTLAKE, TX 762621769
Phone: (817) 767-6209
Type: Mailing
79-1019 HAUKAPILA ST
KEALAKEKUA, HI 967507920
Phone: (808) 322-9311
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $39.
Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.
Last reported payment date: 2024-07-30 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($39).
Total Amount
$39
General + Research + Ownership
Payments
2
Total payment records
General Amount
$39
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | $39 |
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 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 |
|---|---|---|---|---|
| I20231229002395 | I | Nurse Practitioner | HI | 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 76262)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MI | |
| Hospitalist, Family Practice | NC | |
| Internal Medicine | WI | |
| Internal Medicine | WV | |
| Internal Medicine | WA | |
| Family Practice | MT | |
| Internal Medicine, Hospitalist | MI | |
| Family Practice | CA |
Reviews
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