My Mobile Primary Health Care, LLC – Contractor, NPI 1780121277
Contractor
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for My Mobile Primary Health Care, LLC
12380, Northwest 9th Street, Plantation, Broward County, Florida, 33325, United States
PLANTATION, FL 333251305
Phone:
Mailing address matches the actual address.
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: 2024-10-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (103 days ago).
Enrollment records
17
Earliest due date
2026-02-28
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 |
|---|---|---|---|---|
| O20200728002297 | O | Clinic/Group Practice | MD | TBD |
| O20201015000121 | O | Clinic/Group Practice | DC | 2026-02-28 |
| O20230106000032 | O | Clinic/Group Practice | FL | TBD |
| O20230117000479 | O | Clinic/Group Practice | NC | TBD |
| O20230120000018 | O | Clinic/Group Practice | PA | TBD |
| O20230131000274 | O | Clinic/Group Practice | TN | TBD |
| O20230216001673 | O | Clinic/Group Practice | VA | TBD |
| O20230310001078 | O | Clinic/Group Practice | CA | TBD |
| O20230518001624 | O | Clinic/Group Practice | KS | TBD |
| O20230824001902 | O | Clinic/Group Practice | MI | TBD |
| O20230928002433 | O | Clinic/Group Practice | CO | TBD |
| O20231122002425 | O | Clinic/Group Practice | MA | TBD |
| O20240208002323 | O | Clinic/Group Practice | AZ | TBD |
| O20240322002135 | O | Clinic/Group Practice | OH | TBD |
| O20240401000841 | O | Clinic/Group Practice | MO | TBD |
| O20240813003336 | O | Clinic/Group Practice | TX | TBD |
| O20241031001000 | O | Clinic/Group Practice | AL | 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 33325)
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