MIA JASMINE COPELAND-BROCK (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174246128
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MIA JASMINE COPELAND-BROCK (APRN)
40 BOBALA RD
HOLYOKE, MA 010409632
Phone: (413) 536-5473
Type: Location
417 LIBERTY ST
SPRINGFIELD, MA 011043736
Phone: (413) 246-9675
Type: Mailing
165 MAIN ST
MEDWAY, MA 020531584
Phone: (508) 321-3210
Fax: (508) 321-3210
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $265.
Total Amount is formed as General ($265) + Research ($0) + Ownership ($0) = $265.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($98).
Total Amount
$265
General + Research + Ownership
Payments
3
Total payment records
General Amount
$265
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $98 |
| Teva Pharmaceuticals USA, Inc. | $94 |
| E.R. Squibb & Sons, L.L.C. | $74 |
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: 2023-04-18
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 |
|---|---|---|---|---|
| I20230418002472 | I | Nurse Practitioner | MA | 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 |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 01040)
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