KELLY MARONEY VINSON (PA) – Medical Physician Assistant, NPI 1639211089
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for KELLY MARONEY VINSON (PA)
3021 FALLING WATERS BLVD
SUITE A
LINDENHURST, IL 600466793
Phone: (847) 436-0837
Fax: (847) 436-0837
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 66 Open Payments records for all available years, with a total value of $1,292.
Total Amount is formed as General ($1,292) + Research ($0) + Ownership ($0) = $1,292.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Novo Nordisk Inc ($306).
Total Amount
$1,292
General + Research + Ownership
Payments
66
Total payment records
General Amount
$1,292
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
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $306 |
| Lilly USA, LLC | $209 |
| PFIZER INC. | $206 |
| AstraZeneca Pharmaceuticals LP | $116 |
| Exact Sciences Corporation | $93 |
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: 2005-03-24
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 |
|---|---|---|---|---|
| I20050324000338 | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 73 | 44 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 62 | 43 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 37 | 28 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 16 | 14 | $0 |
Insurance plans in this area (ZIP 60046)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL | |
| - | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| Physician Assistant | IL |
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