Mount Dora Pharmacy – Community/Retail Pharmacy, NPI 1063773679
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Mount Dora Pharmacy
17435 US HIGHWAY 441 STE 102
MOUNT DORA, FL 327576750
Phone: (352) 357-1406
Fax: (352) 357-1402
Type: Mailing
17435 US HIGHWAY 441
SUITE-102
EUSTIS, FL 32726
Phone: (352) 357-1406
Fax: (352) 357-1402
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: 2017-10-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (745 days ago).
Enrollment records
1
Earliest due date
2024-05-31
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 |
|---|---|---|---|---|
| O20171017002698 | O | Mass Immunization (Roster Biller Only) | FL | 2024-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 4,596 | 435 | $0 |
| G0008 | Administration of influenza virus vaccine | 72 | 71 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 71 | 70 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 65 | 65 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 64 | 64 | $0 |
Insurance plans in this area (ZIP 32757)
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