MR. MICHAEL KEENE DEMACK (PA C S) – Medical Physician Assistant, NPI 1043347313
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. MICHAEL KEENE DEMACK (PA C S)
PO BOX 2901
PAYSON, AZ 855472901
Phone: (928) 468-8603
Type: Mailing
806 S PONDEROSA ST
PAYSON, AZ 855415541
Phone: (928) 468-8603
Fax: (928) 468-8625
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $55.
Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Abbott Laboratories ($25).
Total Amount
$55
General + Research + Ownership
Payments
3
Total payment records
General Amount
$55
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $25 |
| Philips Electronics North America Corporation | $16 |
| Novo Nordisk Inc | $14 |
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: 2017-06-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170619000691 | I | Physician Assistant | AZ | 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 85547)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine, Internal Medicine | AZ | |
| - | AZ | |
| Nurse Practitioner | AZ | |
| Clinical Social Worker, Mental Health Counselor | NE | |
| Internal Medicine | AZ | |
| Nurse Practitioner | AZ | |
| Mental Health Counselor | AZ | |
| Physician Assistant | AZ | |
| Mental Health Counselor | AZ | |
| Internal Medicine | AZ |
Reviews
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