KELLY L DEBOER (M.D.) – Family Medicine Physician, NPI 1023070257
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,722 FAMILY PRACTICE in FL
Provider Addresses for KELLY L DEBOER (M.D.)
1305 SIXTH STREET
IVCH MEDICAL GROUP
PERU, IL 61354
Phone: (815) 780-5030
Fax: (815) 780-4635
Type: Mailing
2910 BROWNWOOD BLVD
THE VILLAGES, FL 321632032
Phone: (352) 674-1790
Fax: (352) 674-8990
Type: Location
1020 LAKE SUMTER LNDG
THE VILLAGES, FL 321622699
Phone: (352) 674-8905
Fax: (352) 674-8901
Type: Mailing
West Walnut Street, Oglesby, LaSalle County, Illinois, 61348, United States
OGLESBY MEDICAL CLINIC
OGLESBY, IL 613481400
Phone: (815) 883-5388
Fax: (815) 883-3604
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $182.
Total Amount is formed as General ($182) + Research ($0) + Ownership ($0) = $182.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Averitas Pharma Inc. ($132).
Total Amount
$182
General + Research + Ownership
Payments
2
Total payment records
General Amount
$182
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Averitas Pharma Inc. | $132 |
| Novo Nordisk Inc | $50 |
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: 2022-03-09
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 |
|---|---|---|---|---|
| I20220309001893 | I | Family Practice | FL | 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 61354)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | IL | |
| Internal Medicine | IL | |
| - | FL | |
| Family Practice | FL | |
| Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| Nurse Practitioner | NJ | |
| Qualified Audiologist | FL | |
| Nurse Practitioner | FL |
Reviews
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