KEVIN OSBORNE – Physician Assistant, NPI 1700616612

KEVIN OSBORNE is a healthcare provider. based in Lemont, Illinois. specializing in PHYSICIAN ASSISTANT. The NPI Number for KEVIN OSBORNE is 1700616612

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN OSBORNE
NPI
1700616612
Phone
(630) 641-9140
Address
13525 OAK CT
Enumeration Date
5 August 2024
Last Update Date
5 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8083565699
Graduation Year
2024 (2 years ago)
PAC ID
2264955541
Group Practice PAC ID
9638618499
Professional Enrollment ID
I20250327000842
Address ID
HI968141871HO1401XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

356 PHYSICIAN ASSISTANT in HI

Provider Addresses for KEVIN OSBORNE

  • 13525 OAK CT

    LEMONT, IL 604399779

    Phone: (630) 641-9140

    Type: Mailing

  • 1401 S BERETANIA ST STE 102

    HONOLULU, HI 968141871

    Phone: (808) 356-5699

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-03-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250327000842IPhysician AssistantHITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60439)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638618499View full group profile
NameSpecialtyState
Nurse PractitionerHI
Physician AssistantHI
Orthopedic SurgeryHI
Physician AssistantHI
Physician AssistantHI
Physician AssistantHI
Physician AssistantCA
Physician AssistantHI
Physician AssistantHI
Physician AssistantNV

Reviews

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Frequently asked questions

How do payers reference KEVIN OSBORNE?
For KEVIN OSBORNE, use NPI 1700616612 as the unique 10-digit identifier.
Is there an active status for KEVIN OSBORNE?
For scheduling context, KEVIN OSBORNE is shown as active in the registry.
What kind of doctor is KEVIN OSBORNE?
KEVIN OSBORNE is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for KEVIN OSBORNE?
Travel planning: use Lemont, Illinois as the reference point for KEVIN OSBORNE, then confirm.
Does KEVIN OSBORNE accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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