KRISTIN L. WILLIS (PA-C) – Physician Assistant, NPI 1063534253
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for KRISTIN L. WILLIS (PA-C)
1025 S 6TH ST
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Type: Mailing
800 N 1ST ST
SPRINGFIELD, IL 627023719
Phone: (217) 528-7541
Type: Location
800 N 1st St
Springfield, IL 627023719
Phone: (217) 528-7541
Type: Location
7140 E Washington St Ste 100
Indianapolis, IN 462196719
Phone: (317) 832-1780
Fax: (317) 832-1781
Type: Location
30 W Rampart St Ste 250
Shelbyville, IN 461768897
Phone: (317) 398-7644
Type: Location
30 W RAMPART ST
STE 200
SHELBYVILLE, IN 461768846
Phone: (317) 421-2012
Fax: (317) 398-1851
Type: Mailing
2451 INTELLIPLEX DR
STE 260
SHELBYVILLE, IN 461768580
Phone: (317) 398-0121
Fax: (317) 398-0538
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
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 $31.
Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Exact Sciences Corporation ($16).
Total Amount
$31
General + Research + Ownership
Payments
2
Total payment records
General Amount
$31
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exact Sciences Corporation | $16 |
| ABBVIE INC. | $15 |
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: 2021-02-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20070508000388 | I | Physician Assistant | IL | TBD |
| I20210223002565 | I | Physician Assistant | IN | 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 | 183 | 126 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 73 | 63 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 65 | 55 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 31 | 30 | $0 |
| G0008 | Administration of influenza virus vaccine | 31 | 30 | $0 |
Insurance plans in this area (ZIP 62703)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IN | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| Physician Assistant | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| U R O L O G Y | NH | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
Reviews
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