CARYN JOY AXTELL-KELLY (P.A.-C) – Medical Physician Assistant, NPI 1700815958
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for CARYN JOY AXTELL-KELLY (P.A.-C)
PO BOX 2492
RANCHO CUCAMONGA, CA 917292492
Phone: (909) 591-0843
Fax: (909) 591-7226
Type: Mailing
13193, Central Avenue, Chino, San Bernardino County, California, 91710, United States
SUITE 220
CHINO, CA 91710
Phone: (909) 591-0843
Fax: (909) 591-7226
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 192 Open Payments records for all available years, with a total value of $3,844.
Total Amount is formed as General ($3,844) + Research ($0) + Ownership ($0) = $3,844.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Medtronic, Inc. ($1,069).
Total Amount
$3,844
General + Research + Ownership
Payments
192
Total payment records
General Amount
$3,844
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $1,069 |
| ABBVIE INC. | $799 |
| Forte Bio-Pharma LLC | $720 |
| Salix Pharmaceuticals, a division of Bausch Health US, LLC | $449 |
| Collegium Pharmaceutical, Inc. | $143 |
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: 2004-04-26
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 |
|---|---|---|---|---|
| I20040426000907 | I | Physician Assistant | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91729)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Medicine And Rehabilitation, Pain Management | AZ | |
| - | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Clinical Psychologist | CA | |
| - | CA | |
| Neurology, Pain Management | CA |
Reviews
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