JOY R FACKENTHALL (MD) – Family Medicine Physician, NPI 1376626556
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
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Provider Addresses for JOY R FACKENTHALL (MD)
7205, 265th Street Northwest, Stanwood, Snohomish County, Washington, 98292, United States
STANWOOD, WA 982926221
Phone: (360) 629-1504
Type: Location
Everett Post Office, 3102, Hoyt Avenue, Port Gardner, Everett, Snohomish County, Washington, 98201, United States
EVERETT, WA 982065127
Phone: (425) 258-3900
Type: Mailing
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: 2006-11-16
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 |
|---|---|---|---|---|
| I20061116000557 | I | Family Practice | WA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 155 | 119 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 108 | 108 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 100 | 70 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 83 | 83 | $0 |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 78 | 68 | $0 |
Insurance plans in this area (ZIP 98292)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | WA | 83036 | Hemoglobin A1C level | 44 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| - | WA | |
| Nurse Practitioner | WA | |
| Physical Therapist In Private Practice | WA | |
| O T O L A R Y N G O L O G Y | WA | |
| Emergency Medicine | OR | |
| Family Practice | WA | |
| P O D I A T R Y | WA | |
| Family Practice | WA | |
| P O D I A T R Y | WA |
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