MARY KATE MINEMAN (PA-C) – Physician Assistant, NPI 1164998167
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for MARY KATE MINEMAN (PA-C)
9530, South Saint Louis Avenue, Evergreen Park, Worth Township, Cook County, Illinois, 60805, United States
EVERGREEN PARK, IL 608052220
Phone: (708) 209-6783
Type: Mailing
Presence Saint Mary Campus, 2233, West Division Street, Wicker Park, West Town, Chicago, Cook County, Illinois, 60622, United States
CHICAGO, IL 606228151
Phone: (312) 770-2000
Type: Location
18425 WEST CREEK DR
STEF
TINLEY PARK, IL 604772220
Phone: (708) 209-6783
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 42 Open Payments records for all available years, with a total value of $1,033.
Total Amount is formed as General ($1,033) + Research ($0) + Ownership ($0) = $1,033.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: PFIZER INC. ($153).
Total Amount
$1,033
General + Research + Ownership
Payments
42
Total payment records
General Amount
$1,033
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $153 |
| Galderma Laboratories, L.P. | $109 |
| GENZYME CORPORATION | $95 |
| UCB, Inc. | $86 |
| Regeneron Healthcare Solutions, Inc. | $67 |
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: 2018-12-18
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 |
|---|---|---|---|---|
| I20181218002108 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 826 | 162 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 426 | 293 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 362 | 274 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 337 | 228 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 203 | 161 | $0 |
Insurance plans in this area (ZIP 60805)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | IL | |
| P A T H O L O G Y | IL | |
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IL | |
| Physician Assistant | IL | |
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IL | |
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IN | |
| Physician Assistant | IL |
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