JESSICA LAURA GRAVES (PA-C) – Medical Physician Assistant, NPI 1407120066
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
356 PHYSICIAN ASSISTANT in HI
Provider Addresses for JESSICA LAURA GRAVES (PA-C)
2180 MAIN ST
WAILUKU, HI 967931625
Phone: (808) 242-6464
Fax: (808) 242-4292
Type: Mailing
110 E KAAHUMANU AVE
KAHULUI, HI 967322118
Phone: (808) 871-1730
Type: Location
110 E Kaahumanu Ave
Kahului, HI 967322118
Phone: (808) 871-1730
Type: Location
333 S 38TH ST STE E
MUSKOGEE, OK 744014937
Phone: (918) 840-5276
Fax: (918) 877-1312
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 110 Open Payments records for all available years, with a total value of $7,187.
Total Amount is formed as General ($7,187) + Research ($0) + Ownership ($0) = $7,187.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Organogenesis Inc. ($4,392).
Total Amount
$7,187
General + Research + Ownership
Payments
110
Total payment records
General Amount
$7,187
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $4,392 |
| E.R. Squibb & Sons, L.L.C. | $1,240 |
| Regeneron Healthcare Solutions, Inc. | $404 |
| ABBVIE INC. | $253 |
| PFIZER INC. | $177 |
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: 2012-09-05
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 |
|---|---|---|---|---|
| I20120905000250 | I | Physician Assistant | OK | 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 |
|---|---|---|---|---|
| Q4194 | Novachor, per square centimeter | 795 | 35 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 788 | 141 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 459 | 349 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 391 | 257 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 345 | 182 | $0 |
Insurance plans in this area (ZIP 96793)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Micrographic Dermatologic Surgery (Mds) | OK | |
| Physician Assistant | OK | |
| - | OK | |
| Physician Assistant | OK | |
| D E R M A T O L O G Y | OK | |
| Physician Assistant | OK | |
| Physician Assistant | OK | |
| D E R M A T O L O G Y | OK | |
| Physician Assistant | OK | |
| Physician Assistant | OK |
Reviews
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