ABBY MARIE MEDFORD (PA-C) – Physician Assistant, NPI 1114759255
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for ABBY MARIE MEDFORD (PA-C)
414 S State St
Roodhouse, IL 620821544
Phone: (217) 589-4383
Fax: (217) 589-4409
Type: Location
270 Maple Summit Rd
Jerseyville, IL 620522004
Phone: (618) 498-7108
Fax: (618) 498-7919
Type: Location
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 620522000
Phone: (618) 498-7518
Fax: (618) 498-3052
Type: Mailing
2 Myrtle
Hardin, IL 620471002
Phone: (618) 576-9407
Fax: (618) 576-2260
Type: Location
523 S Main St
Carrollton, IL 620161256
Phone: (217) 942-3326
Fax: (217) 942-9833
Type: Location
903 S State St
Jerseyville, IL 620522344
Phone: (618) 639-9255
Fax: (618) 639-8100
Type: Location
220 E County Rd
Jerseyville, IL 620523125
Phone: (618) 498-8467
Fax: (618) 639-2017
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $168.
Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.
Last reported payment date: 2024-12-21 • Largest payer in this snapshot: Amgen Inc. ($59).
Total Amount
$168
General + Research + Ownership
Payments
9
Total payment records
General Amount
$168
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $59 |
| Neurocrine BioSciences Inc. | $25 |
| Dexcom, Inc. | $23 |
| Abbott Laboratories | $18 |
| AstraZeneca Pharmaceuticals LP | $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: 2024-12-13
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 |
|---|---|---|---|---|
| I20241213001482 | I | Physician Assistant | 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 62082)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| - | NY | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Cardiovascular Disease (Cardiology) | MO | |
| G A S T R O E N T E R O L O G Y | MO | |
| - | NC | |
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL |
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