MS. KELLY ANN LUEDERS (DMS, PA-C) – Physician Assistant, NPI 1730135922
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
627 PHYSICIAN ASSISTANT in AR
Provider Addresses for MS. KELLY ANN LUEDERS (DMS, PA-C)
3200 NE REDHAWK DR
BENTONVILLE, AR 727123873
Phone: (479) 367-2688
Fax: (479) 367-2689
Type: Location
2103 Slack St
Pea Ridge, AR 727514005
Phone: (479) 765-1980
Type: Location
3101 SE 14TH ST
BENTONVILLE, AR 727124900
Phone: (479) 250-1053
Fax: (479) 250-0923
Type: Mailing
2110 W WALNUT ST
ROGERS, AR 727563246
Phone: (479) 202-7035
Type: Mailing
Fayetteville Post Office, 12, West Dickson Street, Fayetteville, Washington County, Arkansas, 72701, United States
FAYETTEVILLE, AR 72702
Phone: (479) 571-6038
Fax: (479) 582-0222
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $41.
Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.
Last reported payment date: 2023-10-25 • Largest payer in this snapshot: PFIZER INC. ($25).
Total Amount
$41
General + Research + Ownership
Payments
2
Total payment records
General Amount
$41
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $25 |
| GlaxoSmithKline, LLC. | $17 |
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: 2025-05-15
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 |
|---|---|---|---|---|
| I20110310001004 | I | Physician Assistant | AR | TBD |
| I20250515001209 | I | Physician Assistant | MO | 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 | 149 | 147 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 120 | 12 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 86 | 86 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 76 | 76 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 62 | 31 | $0 |
Insurance plans in this area (ZIP 72712)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | OK | |
| Family Practice, Geriatric Medicine | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| - | AR |
Reviews
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