KYLE HOLLENBACK – Medical Physician Assistant, NPI 1932574381
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,546 PHYSICIAN ASSISTANT in ID
Provider Addresses for KYLE HOLLENBACK
486 W 1st Ave
Glenns Ferry, ID 836232701
Phone: (208) 366-7416
Type: Location
486 W 1ST AVE
GLENNS FERRY, ID 836232701
Phone:
Type: Mailing
2280 AMERICAN LEGION BLVD
MOUNTAIN HOME, ID 836473142
Phone: (208) 587-3988
Fax: (208) 587-3324
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2022-01-11
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20220111002530 | I | Physician Assistant | UT | 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 | 115 | 109 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 33 | 33 | $0 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 28 | 11 | $0 |
| 71046 | X-ray of chest, 2 views | 18 | 18 | $0 |
| 81003 | Automated urinalysis test | 17 | 16 | $0 |
Insurance plans in this area (ZIP 83623)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | UT | |
| - | OR | |
| Diagnostic Radiology | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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