KEVIN CLARK ROBERTSON (PA) – Physician Assistant, NPI 1295955441
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for KEVIN CLARK ROBERTSON (PA)
444 S SAN VICENTE BLVD
SUITE 800
LOS ANGELES, CA 90048
Phone: (310) 423-9716
Type: Mailing
125 EUCALYPTUS DR
EL SEGUNDO, CA 902453839
Phone: (310) 322-4278
Fax: (310) 322-6660
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $637.
Total Amount is formed as General ($637) + Research ($0) + Ownership ($0) = $637.
Last reported payment date: 2024-10-04 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($274).
Total Amount
$637
General + Research + Ownership
Payments
6
Total payment records
General Amount
$637
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medical Device Business Services, Inc. | $274 |
| Amgen Inc. | $164 |
| Pacira Pharmaceuticals Incorporated | $122 |
| Ethicon US, LLC | $77 |
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: 2021-02-25
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 |
|---|---|---|---|---|
| I20210225002146 | I | Physician Assistant | GA | 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 | 145 | 87 | $0 |
| 73110 | X-ray of wrist, minimum of 3 views | 77 | 40 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 52 | 44 | $0 |
| 73130 | X-ray of hand, minimum of 3 views | 50 | 37 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 49 | 49 | $0 |
Insurance plans in this area (ZIP 90048)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Orthopedic Surgery, Hand Surgery | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Physical Therapist In Private Practice | FL | |
| - | GA | |
| Orthopedic Surgery | PA | |
| Physical Therapist In Private Practice | GA | |
| Physician Assistant | GA | |
| - | GA |
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