KENNETH JAMES MINIELLY (M.D.) – Dermatology Physician, NPI 1699125062
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
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Provider Addresses for KENNETH JAMES MINIELLY (M.D.)
PO BOX 19644
SPRINGFIELD, IL 627949644
Phone: (217) 545-8000
Fax: (217) 545-7438
Type: Mailing
North Rutledge Street, Springfield, Sangamon County, Illinois, 62702, United States
SPRINGFIELD, IL 627024968
Phone: (217) 545-8000
Fax: (217) 545-7438
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 116 Open Payments records for all available years, with a total value of $2,447.
Total Amount is formed as General ($2,447) + Research ($0) + Ownership ($0) = $2,447.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Janssen Biotech, Inc. ($898).
Total Amount
$2,447
General + Research + Ownership
Payments
116
Total payment records
General Amount
$2,447
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 |
|---|---|
| Janssen Biotech, Inc. | $898 |
| ABBVIE INC. | $245 |
| Novartis Pharmaceuticals Corporation | $177 |
| Regeneron Healthcare Solutions, Inc. | $143 |
| Organogenesis Inc. | $112 |
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: 2020-08-13
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 |
|---|---|---|---|---|
| I20200813003676 | I | Dermatology | KY | 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 | 3,225 | 548 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,441 | 1,035 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 926 | 720 | $0 |
| 11106 | Incision biopsy, first skin growth | 471 | 430 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 435 | 353 | $0 |
Insurance plans in this area (ZIP 62794)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | KY | |
| D E R M A T O L O G Y | IN | |
| Physician Assistant | KY | |
| D E R M A T O L O G Y | MO | |
| D E R M A T O L O G Y | KY | |
| D E R M A T O L O G Y | AZ | |
| Nurse Practitioner | KY | |
| Physician Assistant | KY | |
| Nurse Practitioner | KY | |
| Physician Assistant | KY |
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