DR. KELLI RAYNELL FAVATA (M.D.) – Vascular Specialist/Technologist Cardiovascular, NPI 1184822348
Vascular Specialist/Technologist Cardiovascular
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,585 INTERNAL MEDICINE in AZ
Provider Addresses for DR. KELLI RAYNELL FAVATA (M.D.)
3530 S VAL VISTA DR STE B210
GILBERT, AZ 852977318
Phone: (800) 991-6117
Type: Location
North Alma School Road, Sunridge Townhomes, Chandler, Maricopa County, Arizona, 85202-7321, United States
160
CHANDLER, AZ 852245941
Phone: (480) 963-1853
Fax: (480) 963-1854
Type: Mailing
606, North Country Club Drive, Mesa, Maricopa County, Arizona, 85201, United States
5
MESA, AZ 852015700
Phone: (480) 776-2982
Fax: (480) 726-0695
Type: Location
18444 N 25TH AVE STE 310
PHOENIX, AZ 850231266
Phone: (866) 974-2673
Fax: (866) 939-2673
Type: Mailing
3420 S MERCY RD STE 211
GILBERT, AZ 852970424
Phone: (866) 974-2673
Fax: (866) 939-2673
Type: Location
3820 NORTHDALE BLVD STE 201
TAMPA, FL 336241893
Phone: (800) 911-6117
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 32 Open Payments records for all available years, with a total value of $1,480.
Total Amount is formed as General ($1,480) + Research ($0) + Ownership ($0) = $1,480.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: AngioDynamics, Inc. ($1,008).
Total Amount
$1,480
General + Research + Ownership
Payments
32
Total payment records
General Amount
$1,480
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AngioDynamics, Inc. | $1,008 |
| Medtronic, Inc. | $326 |
| Boston Scientific Corporation | $89 |
| TACTILE SYSTEMS TECHNOLOGY INC | $43 |
| Tactile Systems Technology 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: 2012-05-26
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 |
|---|---|---|---|---|
| I20120526000028 | I | Internal Medicine | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 32 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 26 | $0 |
| 36465 | Injection of chemical agent into single incompetent vein of leg using ultrasound guidance | 26 | 16 | $0 |
Insurance plans in this area (ZIP 85297)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | AZ | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 65 | 38 |
| INTERNAL MEDICINE | AZ | 93922 | Ultrasound study of arteries of both arms and legs | 49 | 49 |
| INTERNAL MEDICINE | AZ | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 106 | 63 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | FL | |
| Vascular Surgery | FL | |
| Cardiac Surgery, Thoracic Surgery, Vascular Surgery | AZ | |
| Vascular Surgery, General Surgery | FL | |
| General Surgery | FL | |
| General Surgery | NY | |
| Vascular Surgery | OH | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | ME | |
| Diagnostic Radiology | CA |
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