DR. JEFFREY K MCKENNA (MD) – MOHS-Micrographic Surgery Physician, NPI 1396713780
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
Provider Addresses for DR. JEFFREY K MCKENNA (MD)
3024 E Empire St Ste Eandf
Bloomington, IL 617045402
Phone: (309) 451-3376
Fax: (309) 452-3376
Type: Location
4909 N Glen Park Place Rd
Peoria, IL 616144676
Phone: (309) 674-7546
Fax: (309) 282-0500
Type: Location
530 Park Ave E Ste 204
Princeton, IL 613563902
Phone: (815) 842-4000
Fax: (309) 452-3376
Type: Location
920 West St Ste 212
Peru, IL 613542769
Phone: (815) 842-4000
Fax: (815) 223-8736
Type: Location
600 S 13th St
Pekin, IL 615544936
Phone: (309) 693-7788
Fax: (309) 452-3376
Type: Location
3024, East Empire Street, Bloomington, McLean County, Illinois, 61704, United States
SECOND FLOOR STE E & F
BLOOMINGTON, IL 617045402
Phone: (309) 451-3376
Fax: (309) 452-3376
Type: Mailing
Deerpath Road, Charleston, Coles County, Illinois, 61920, United States
CHARLESTON, IL 619209427
Phone: (217) 234-8000
Fax: (217) 234-8003
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 218 Open Payments records for all available years, with a total value of $4,067.
Total Amount is formed as General ($4,067) + Research ($0) + Ownership ($0) = $4,067.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: PFIZER INC. ($594).
Total Amount
$4,067
General + Research + Ownership
Payments
218
Total payment records
General Amount
$4,067
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2007-09-11
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 |
|---|---|---|---|---|
| I20070911000657 | I | Dermatology | 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 |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 780 | 676 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 429 | 90 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 331 | 228 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 223 | 196 | $0 |
| 17313 | Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks | 210 | 180 | $0 |
Insurance plans in this area (ZIP 61704)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | IL | 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 171 | 164 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| Physician Assistant | WI | |
| - | IL | |
| Nurse Practitioner | IL | |
| D E R M A T O L O G Y | IL | |
| Nurse Practitioner | WI |
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