MRS. HALEY RANAE GOULSON (PA-C) – Physician Assistant, NPI 1417283938
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MRS. HALEY RANAE GOULSON (PA-C)
17495 SOUTH LAGRANGE ROAD
TINLEY PARK, IL 60487
Phone: (708) 226-7000
Fax: (708) 226-7192
Type: Mailing
17495 South LaGrange Road
Tinley Park, IL 60487
Phone: (708) 226-7000
Fax: (708) 226-7192
Type: Location
10 HEALTH SERVICES DR
DEKALB, IL 601159600
Phone: (815) 756-5255
Fax: (815) 756-9944
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $940.
Total Amount is formed as General ($940) + Research ($0) + Ownership ($0) = $940.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Lilly USA, LLC ($241).
Total Amount
$940
General + Research + Ownership
Payments
13
Total payment records
General Amount
$940
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $241 |
| E.R. Squibb & Sons, L.L.C. | $228 |
| Janssen Biotech, Inc. | $166 |
| Incyte Corporation | $99 |
| JAZZ PHARMACEUTICALS INC. | $89 |
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: 2014-01-28
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 |
|---|---|---|---|---|
| I20140128001140 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 370 | 175 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 110 | 87 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 73 | 55 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 61 | 39 | $0 |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 39 | 32 | $0 |
Insurance plans in this area (ZIP 60487)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Diagnostic Radiology, Interventional Radiology | IL | |
| P A T H O L O G Y | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| G A S T R O E N T E R O L O G Y | IL | |
| Internal Medicine | IL | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal Medicine | MN | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL |
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