MRS. WIETSKE WILLEMSMA MOORE (CFNP) – Family Nurse Practitioner, NPI 1235291394
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. WIETSKE WILLEMSMA MOORE (CFNP)
12548 MOUNTAIN RD
LOVETTSVILLE, VA 201802609
Phone: (703) 554-4527
Type: Mailing
Unity Health Care - Upper Cardoza, 3020, 14th Street Northwest, Columbia Heights, Washington, Washington, D.C., 20009, United States
WASHINGTON, DC 200096865
Phone: (202) 745-4300
Fax: (202) 745-5907
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: 2024-10-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20031120000990 | I | Nurse Practitioner | NM | TBD |
| I20240808002897 | I | Nurse Practitioner | AZ | TBD |
| I20240829002070 | I | Nurse Practitioner | VT | TBD |
| I20241002003263 | I | Nurse Practitioner | IL | 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 20180)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Certified Registered Nurse Anesthetist (Crna) | NM | |
| General Surgery | NM | |
| Nurse Practitioner | NM | |
| Sleep Medicine, Internal Medicine, Sleep Medicine | NV | |
| Cardiovascular Disease (Cardiology) | NM | |
| Orthopedic Surgery | NY | |
| - | AZ | |
| Orthopedic Surgery | WA | |
| - | OK |
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