NEUROMUSCULOSKELETAL REHABILITATION MEDICINE CONSULTANT – Physical Medicine & Rehabilitation Physician, NPI 1265495816
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for NEUROMUSCULOSKELETAL REHABILITATION MEDICINE CONSULTANT
Irving Roofing Contractors - IrvingRoofingPro, 7750, North MacArthur Boulevard, Irving, Dallas County, Texas, 75063, United States
STE 120-338
IRVING, TX 750637514
Phone: (817) 284-9850
Fax: (949) 863-6838
Type: Mailing
West 15th Street, Plano, Collin County, Texas, 75-75, United States
PLANO, TX 750757526
Phone: (972) 378-6908
Fax: (972) 409-0338
Type: Location
3600 MAPLESHADE LN
PLANO, TX 750755715
Phone: (972) 849-0164
Fax: (972) 999-4634
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: 2006-02-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-08-31 (85 days away).
Enrollment records
1
Earliest due date
2026-08-31
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 |
|---|---|---|---|---|
| O20060213000822 | O | Clinic/Group Practice | TX | 2026-08-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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 75063)
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