KELLY L DUSTIN (DO) – Family Medicine Physician, NPI 1114957362
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
969 FAMILY PRACTICE in ID
Provider Addresses for KELLY L DUSTIN (DO)
Eastland Drive, Twin Falls, Twin Falls County, Idaho, 83301, United States
TWIN FALLS, ID 833016856
Phone: (208) 734-3312
Fax: (208) 734-5036
Type: Mailing
21 WINN DR
REXBURG, ID 834405277
Phone: (208) 881-5222
Fax: (877) 441-4715
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $134.
Total Amount is formed as General ($134) + Research ($0) + Ownership ($0) = $134.
Last reported payment date: 2024-09-18 • Largest payer in this snapshot: ABBVIE INC. ($35).
Total Amount
$134
General + Research + Ownership
Payments
7
Total payment records
General Amount
$134
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2009-06-29
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 |
|---|---|---|---|---|
| I20090629000517 | I | Family Practice | ID | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 85 | 51 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 46 | 40 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 39 | 31 | $0 |
| 83036 | Hemoglobin a1c level | 38 | 28 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 31 | 31 | $0 |
Insurance plans in this area (ZIP 83301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | ID | |
| Physician Assistant | WA | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| Physician Assistant | KS | |
| Physician Assistant | ID | |
| Physician Assistant | ID |
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