AMANDA GRACE KIESSEL (PA-C) – Physician Assistant, NPI 1669929063
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,685 PHYSICIAN ASSISTANT in AZ
Provider Addresses for AMANDA GRACE KIESSEL (PA-C)
CORNER OF ROUTES 12 AND 7
FORT DEFIANCE, AZ 86504
Phone: (928) 729-8000
Type: Location
1010 Three Springs Blvd
Durango, CO 813018296
Phone: (970) 247-4300
Type: Location
604 S Rio Grande Ave
Aztec, NM 874102260
Phone: (505) 334-2664
Fax: (505) 334-7759
Type: Location
Mercy Regional Medical Center, 1010, Three Springs Boulevard, Durango, La Plata County, Colorado, 81301, United States
DURANGO, CO 813018296
Phone:
Type: Mailing
2577 MAIN AVE
DURANGO, CO 813015919
Phone: (970) 247-8382
Fax: (970) 259-4403
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: 2022-03-03
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 |
|---|---|---|---|---|
| I20190219002308 | I | Physician Assistant | CO | TBD |
| I20220303002320 | I | Physician Assistant | NM | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 159 | 147 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 158 | 158 | $0 |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | 85 | 82 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 71 | 68 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 59 | 59 | $0 |
Insurance plans in this area (ZIP 86504)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NM | |
| Physician Assistant | ME | |
| Nurse Practitioner | AZ | |
| Physician Assistant | CO | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | NM |
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