JESSICA KIERSTEN MATTSON (PA-C) – Medical Physician Assistant, NPI 1669637807
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
356 PHYSICIAN ASSISTANT in HI
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Provider Addresses for JESSICA KIERSTEN MATTSON (PA-C)
24, North Church Street, Happy Valley, Wailuku, Maui County, Hawaii, 96793, United States
403
WAILUKU, HI 967931680
Phone: (603) 321-1099
Type: Mailing
1329 LUSITANA ST STE 807
HONOLULU, HI 968132435
Phone: (603) 321-1099
Type: Mailing
3400 DOUGLAS BLVD STE 170
ROSEVILLE, CA 956614281
Phone: (916) 740-3721
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 135 Open Payments records for all available years, with a total value of $15,449.
Total Amount is formed as General ($15,449) + Research ($0) + Ownership ($0) = $15,449.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Dexcom, Inc. ($12,952).
Total Amount
$15,449
General + Research + Ownership
Payments
135
Total payment records
General Amount
$15,449
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $12,952 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $394 |
| Corcept Therapeutics | $280 |
| Bayer Healthcare Pharmaceuticals Inc. | $189 |
| UCB, Inc. | $181 |
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: 2021-02-11
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 |
|---|---|---|---|---|
| I20210211003532 | I | Physician Assistant | CA | 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 96793)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Nurse Practitioner | TX | |
| E N D O C R I N O L O G Y | WA | |
| D E R M A T O L O G Y | FL | |
| N E U R O L O G Y | NY | |
| Critical Care (Intensivists), Pulmonary Disease, Hospitalist | MI | |
| Registered Dietitian Or Nutrition Professional | WA | |
| E N D O C R I N O L O G Y | GA | |
| Neuropsychiatry, Psychiatry | CA | |
| Internal Medicine, Rheumatology | CA |
Reviews
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