MRS. MARY ANNE KIDWELL (PA-C) – Medical Physician Assistant, NPI 1649365289
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,232 PHYSICIAN ASSISTANT in FL
Provider Addresses for MRS. MARY ANNE KIDWELL (PA-C)
5352 LINTON BLVD
DELRAY BEACH, FL 334846514
Phone: (561) 498-4440
Type: Location
Box Canyon Drive, Las Vegas, Clark County, Nevada, 89108-4577, United States
LAS VEGAS, NV 891938978
Phone: (702) 216-3346
Fax: (702) 671-6883
Type: Mailing
595, Lake Mead Parkway, Henderson, Clark County, Nevada, 89015, United States
HENDERSON, NV 890157015
Phone: (702) 566-5500
Fax: (702) 558-7238
Type: Location
5190 LAS VERDES CIR APT 212
DELRAY BEACH, FL 334848048
Phone: (702) 332-4191
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-02-13 • Largest payer in this snapshot: Boston Scientific Corporation ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $20 |
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: 2025-01-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20040722000824 | I | Physician Assistant | NV | TBD |
| I20241016004119 | I | Physician Assistant | SD | TBD |
| I20250106003797 | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 330 | 33 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 132 | 107 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 128 | 32 | $0 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 88 | 27 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 67 | 38 | $0 |
Insurance plans in this area (ZIP 33484)
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Group practice members
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