MECHIELL DEMETRIUS TUCKER (PA) – Physician Assistant, NPI 1730101783
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MECHIELL DEMETRIUS TUCKER (PA)
102, Executive Way, DeSoto, Dallas County, Texas, 75115, United States
DESOTO, TX 751152388
Phone: (469) 941-4029
Type: Location
2727 Bolton Boone Dr
Ste 107
DeSoto, TX 751152019
Phone: (214) 453-2030
Fax: (972) 283-5060
Type: Location
4501 Joe Ramsey Blvd E Ste 100
Greenville, TX 754017843
Phone: (903) 408-5800
Fax: (903) 455-8232
Type: Location
3008, Bayside Drive, Lakeside Village, Glen Hill, Rockwall, Rockwall County, Texas, 75087, United States
ROCKWALL, TX 750875307
Phone: (469) 951-9984
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 $290.
Total Amount is formed as General ($290) + Research ($0) + Ownership ($0) = $290.
Last reported payment date: 2024-03-20 • Largest payer in this snapshot: Novo Nordisk Inc ($166).
Total Amount
$290
General + Research + Ownership
Payments
19
Total payment records
General Amount
$290
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-20
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: 2004-06-09
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 |
|---|---|---|---|---|
| I20040609001312 | 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 75115)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | TX | |
| Nephrology, Internal Medicine, Hospitalist | WI | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX |
Reviews
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