KENNETH C. HOLBROOK (PA) – Physician Assistant, NPI 1194790139
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for KENNETH C. HOLBROOK (PA)
2041 MESA VALLEY WAY
SUITE 100
AUSTELL, GA 301066828
Phone: (770) 944-1100
Fax: (770) 944-6469
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 23 Open Payments records for all available years, with a total value of $704.
Total Amount is formed as General ($704) + Research ($0) + Ownership ($0) = $704.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Globus Medical, Inc. ($679).
Total Amount
$704
General + Research + Ownership
Payments
23
Total payment records
General Amount
$704
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Globus Medical, Inc. | $679 |
| SI-BONE, INC. | $25 |
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: 2008-11-19
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 |
|---|---|---|---|---|
| I20081119000130 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 138 | 107 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 111 | 77 | $0 |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 98 | 86 | $0 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 96 | 61 | $0 |
| 20552 | Injection of trigger points, 1-2 muscles | 66 | 52 | $0 |
Insurance plans in this area (ZIP 30106)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | GA | 20610 | Aspiration and/or injection of large joint or joint capsule | 38 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| Physical Therapist In Private Practice | GA | |
| Physician Assistant | GA | |
| - | GA | |
| Diagnostic Radiology | GA | |
| Physical Therapist In Private Practice | GA | |
| Occupational Therapist In Private Practice | NJ | |
| Nurse Practitioner | GA | |
| - | GA | |
| - | GA |
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