CVS Pharmacy # 04879 – Pharmacy, NPI 1962715136
Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CVS Pharmacy # 04879
1 CVS DR
P O BOX 1075 - PROVIDER ENROLLMENTS
WOONSOCKET, RI 028956146
Phone: (401) 765-1500
Fax: (401) 770-7108
Type: Mailing
827 E MILAM ST
MEXIA, TX 766672447
Phone: (254) 472-0306
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: 2010-11-05
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (197 days ago).
Enrollment records
1
Earliest due date
2025-11-30
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 |
|---|---|---|---|---|
| O20101105000482 | O | Pharmacy | TX | 2025-11-30 |
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 | 260 | 33 | $0 |
| G0008 | Administration of influenza virus vaccine | 149 | 148 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 127 | 127 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 76 | 76 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 75 | 75 | $0 |
Insurance plans in this area (ZIP 02895)
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