PalliCare – Primary Care Nurse Practitioner, NPI 1407553936

PalliCare is a healthcare provider. based in Texarkana, Texas. specializing in Primary Care Nurse Practitioner. The NPI Number for PalliCare is 1407553936

Main info

Organization
Name
PalliCare
NPI
1407553936
Phone
(972) 632-9642
Address
5803 STONERIDGE DR
Authorized Official
JONATHAN FLUHART CEO
Enumeration Date
15 February 2023
Last Update Date
15 February 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness80
Years active:3State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for PalliCare

  • 5803 STONERIDGE DR

    TEXARKANA, TX 755031461

    Phone: (972) 632-9642

    Mailing address matches the actual address.

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: 2023-12-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20231215002103OClinic/Group PracticeNYTBD

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.

Verify on CMS Revalidation Lookup Tool

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 75503)

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Reviews

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Frequently asked questions

Where can patients find PalliCare's NPI?
You can confirm PalliCare with NPI 1407553936; it appears in the national provider directory.
Is PalliCare currently active in the NPI registry?
CMS-published data lists PalliCare as an active registrant.
What kind of provider is PalliCare?
The page reflects Primary Care Nurse Practitioner for PalliCare. Clinical services aligned with this taxonomy classification.
Where is PalliCare's primary listing?
We display Texarkana, Texas because that is what the record indicates for PalliCare.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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