KIMBERLY ANNE CHANNELS (PA) – Physician Assistant, NPI 1053443796
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for KIMBERLY ANNE CHANNELS (PA)
15320 AMBERLY DR
STE A
TAMPA, FL 336471647
Phone: (813) 977-2090
Fax: (813) 977-9107
Mailing address matches the actual address.
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 $179.
Total Amount is formed as General ($179) + Research ($0) + Ownership ($0) = $179.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: Novo Nordisk Inc ($114).
Total Amount
$179
General + Research + Ownership
Payments
2
Total payment records
General Amount
$179
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $114 |
| ABBVIE INC. | $64 |
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: 2018-12-20
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 |
|---|---|---|---|---|
| I20181220000469 | I | Physician Assistant | FL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 276 | 106 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 164 | 82 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 98 | 63 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 35 | 14 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 32 | 24 | $0 |
Insurance plans in this area (ZIP 33647)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | FL | |
| - | FL | |
| Internal Medicine | FL | |
| Internal Medicine | FL | |
| Family Practice | FL | |
| Internal Medicine | GA | |
| Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL |
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