KELLY ANN DOTY (PA) – Physician Assistant, NPI 1003867474
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for KELLY ANN DOTY (PA)
4301 NORTH STAR WAY
MODESTO, CA 953569262
Phone:
Type: Mailing
1081 N CHINA LAKE BLVD
RIDGECREST, CA 935553130
Phone:
Type: Mailing
1111 N CHINA LAKE BLVD STE 190
RIDGECREST, CA 935553131
Phone: (760) 499-3855
Fax: (760) 499-3870
Type: Location
Emanuel Medical Center, 825, Delbon Avenue, Turlock, Stanislaus County, California, 95382, United States
TURLOCK, CA 953822016
Phone: (209) 342-2300
Fax: (209) 524-4240
Type: Location
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: 2014-08-14
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 |
|---|---|---|---|---|
| I20040423001220 | I | Physician Assistant | CA | TBD |
| I20140814001821 | I | Physician Assistant | TX | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 11 | 11 | $0 |
Insurance plans in this area (ZIP 95356)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| - | WV | |
| Internal Medicine | CA | |
| Certified Registered Nurse Anesthetist (Crna) | NM | |
| - | CA | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Nurse Practitioner | CA |
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