DR. ERIC DANIEL WIRTZ (M.D.) – Otolaryngology Physician, NPI 1073717864
Otolaryngology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. ERIC DANIEL WIRTZ (M.D.)
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 782365638
Phone: (210) 539-9582
Type: Location
1, Jarrett White Road, Moanalua Gardens, Honolulu, Honolulu County, Hawaii, 96859, United States
TRIPLER ARMY MEDICAL CENTER
HONOLULU, HI 96859
Phone: (808) 433-3181
Type: Mailing
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 782344504
Phone: (210) 539-9582
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $37.
Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.
Last reported payment date: 2024-07-17 • Largest payer in this snapshot: AXOGEN ($37).
Total Amount
$37
General + Research + Ownership
Payments
1
Total payment records
General Amount
$37
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AXOGEN | $37 |
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: 2024-07-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20201210000951 | I | Otolaryngology | HI | TBD |
| I20240724001725 | I | Otolaryngology | NC | 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 78236)
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