MINUTECLINIC LLC – Family Nurse Practitioner, NPI 1134191836
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MINUTECLINIC LLC
12280 Lake Underhill Rd
Orlando, FL 328255009
Phone: (866) 389-2727
Type: Location
6015 E Brown Rd
Mesa, AZ 852054452
Phone: (866) 389-2727
Type: Location
2782 N Cobb Pkwy
Kennesaw, GA 301523472
Phone: (866) 389-2727
Type: Location
PO BOX 772
MINUTECLINIC CREDENTIALING-MC2295
WOONSOCKET, RI 028950784
Phone: (866) 389-2727
Fax: (401) 406-3539
Type: Mailing
7955 TUCKERMAN LN
ROCKVILLE, MD 208543243
Phone: (866) 389-2727
Fax: (401) 406-3539
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: 2007-02-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (892 days ago).
Enrollment records
5
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| O20041216000704 | O | Clinic/Group Practice | DC | TBD |
| O20050127001141 | O | Clinic/Group Practice | MD | TBD |
| O20051024000186 | O | Clinic/Group Practice | GA | 2025-11-30 |
| O20070131000662 | O | Clinic/Group Practice | AZ | 2023-12-31 |
| O20070217000007 | O | Clinic/Group Practice | FL | TBD |
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32825)
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