DR. MARC ALAN HULTQUIST (D.O.) – Pediatrics Physician, NPI 1063595593
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MARC ALAN HULTQUIST (D.O.)
4301 Mow-Way Rd
Reynolds Army Hospital (ATTN: MCUA-QC, Ms. Prescott)
Fort Sill, OK 735036300
Phone: (580) 458-2134
Fax: (580) 458-2314
Type: Location
4301 MOW-WAY RD
REYNOLDS ARMY HOSPITAL (ATTN: MCUA-QC, MS. PRESCOTT)
FORT SILL, OK 735036300
Phone: (580) 458-2134
Fax: (580) 458-2314
Type: Mailing
12205 COUNTY LINE RD STE C
MADISON, AL 357587720
Phone: (256) 258-8319
Fax: (256) 489-4070
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $519.
Total Amount is formed as General ($519) + Research ($0) + Ownership ($0) = $519.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: ALK-Abello, Inc ($509).
Total Amount
$519
General + Research + Ownership
Payments
2
Total payment records
General Amount
$519
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ALK-Abello, Inc | $509 |
| Corium, LLC | $11 |
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: 2024-08-22
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 |
|---|---|---|---|---|
| I20240822000220 | I | Pediatric Medicine | AL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73503)
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Reviews
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