DR. KELLY M FARROLL (MD) – Family Medicine Physician, NPI 1063503704
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,041 FAMILY PRACTICE in IL
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Provider Addresses for DR. KELLY M FARROLL (MD)
2166 MADISON AVE
GRANITE CITY, IL 620404700
Phone: (618) 452-3301
Fax: (618) 452-3312
Type: Mailing
103, North Oak Street, Petersburg, O'Fallon, Saint Clair County, Illinois, 62269, United States
O FALLON, IL 622691165
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $81.
Total Amount is formed as General ($81) + Research ($0) + Ownership ($0) = $81.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($45).
Total Amount
$81
General + Research + Ownership
Payments
4
Total payment records
General Amount
$81
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $45 |
| Hologic Sales and Service, LLC | $22 |
| Novo Nordisk Inc | $14 |
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: 2004-03-27
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 |
|---|---|---|---|---|
| I20040327000375 | I | Family Practice | IL | 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 62040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery, Colorectal Surgery (Proctology) | GA | |
| Family Practice | IL | |
| General Surgery | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| Family Practice | MO | |
| General Surgery | IL | |
| Family Practice | IL |
Reviews
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