KELLY W TOLER (PA C) – Physician Assistant, NPI 1083608244
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for KELLY W TOLER (PA C)
2400, Bellevue Road, Dublin, Laurens County, Georgia, 31021, United States
SUITE 21-A
DUBLIN, GA 310212885
Phone: (478) 275-7202
Fax: (478) 274-8418
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 156 Open Payments records for all available years, with a total value of $2,693.
Total Amount is formed as General ($2,693) + Research ($0) + Ownership ($0) = $2,693.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($564).
Total Amount
$2,693
General + Research + Ownership
Payments
156
Total payment records
General Amount
$2,693
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $564 |
| Janssen Biotech, Inc. | $415 |
| E.R. Squibb & Sons, L.L.C. | $344 |
| UCB, Inc. | $274 |
| GENZYME CORPORATION | $135 |
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: 2004-11-10
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 |
|---|---|---|---|---|
| I20041110000057 | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 3,574 | 457 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,456 | 921 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 788 | 490 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 624 | 489 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 433 | 380 | $0 |
Insurance plans in this area (ZIP 31021)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | GA | 11101 | Biopsy of each additional growth of skin and/or tissue | 282 | 202 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| D E R M A T O L O G Y | GA | |
| - | GA | |
| D E R M A T O L O G Y | SC | |
| Micrographic Dermatologic Surgery (Mds), Micrographic Dermatologic Surgery (Mds), Dermatology, Dermatology | TX | |
| P A T H O L O G Y | GA | |
| Physician Assistant | GA |
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