DR. KAIDDEN KELLY (DMSC, PA-C) – Physician Assistant, NPI 1083124135
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
356 PHYSICIAN ASSISTANT in HI
Provider Addresses for DR. KAIDDEN KELLY (DMSC, PA-C)
PO BOX 818
KAMUELA, HI 967430818
Phone: (808) 885-5900
Type: Mailing
64-1035 MAMALAHOA HWY STE F
KAMUELA, HI 967438440
Phone: (808) 885-5900
Type: Location
62-100 KAUNAOA DR
KAMUELA, HI 967439749
Phone:
Type: Mailing
75-184 HUALALAI RD STE 302
KAILUA KONA, HI 967401719
Phone: (808) 329-0111
Fax: (808) 365-5811
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $362.
Total Amount is formed as General ($362) + Research ($0) + Ownership ($0) = $362.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: ABBVIE INC. ($226).
Total Amount
$362
General + Research + Ownership
Payments
16
Total payment records
General Amount
$362
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $226 |
| PFIZER INC. | $65 |
| Bioventus LLC | $32 |
| Lundbeck LLC | $25 |
| Teva Pharmaceuticals USA, Inc. | $15 |
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: 2017-12-08
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 |
|---|---|---|---|---|
| I20171208002461 | I | Physician Assistant | HI | 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 96743)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management, Anesthesiology, Anesthesiology | TX | |
| General Practice | HI | |
| Nurse Practitioner | HI | |
| Nurse Practitioner | HI | |
| Sports Medicine, Interventional Pain Management | HI | |
| Nurse Practitioner | HI | |
| - | HI | |
| Nurse Practitioner | HI | |
| Pain Management, Physical Medicine And Rehabilitation | OH | |
| Nurse Practitioner | CA |
Reviews
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