MS. CANDACE BREAUX (AGACNP) – Gerontology Nurse Practitioner, NPI 1366676132
Gerontology Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. CANDACE BREAUX (AGACNP)
2929 Calder St
Suite 100
Beaumont, TX 777021845
Phone: (409) 833-9797
Fax: (409) 839-3174
Type: Location
1400, Saint Joseph Parkway, Houston, Harris County, Texas, 77002, United States
HOUSTON, TX 770028237
Phone: (409) 833-9797
Fax: (409) 839-3174
Type: Location
South Damen Avenue, Near West Side, Illinois Medical District, Chicago, Cook County, Illinois, 60612, United States
CHICAGO, IL 606081169
Phone: (312) 262-2739
Fax: (312) 564-4059
Type: Mailing
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: 2024-12-05
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 |
|---|---|---|---|---|
| I20181015000300 | I | Nurse Practitioner | TX | TBD |
| I20241205002747 | I | Nurse Practitioner | TN | 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 77702)
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