KATHLEEN KEITHLEY (PA-C) – Medical Physician Assistant, NPI 1760457352

KATHLEEN KEITHLEY (PA-C) is a healthcare provider. based in Belleville, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 2003029518 (MO). The NPI Number for KATHLEEN KEITHLEY (PA-C) is 1760457352

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN KEITHLEY (PA-C)
NPI
1760457352
Phone
(618) 233-6044
Address
340 W LINCOLN ST
Enumeration Date
17 February 2006
Last Update Date
5 November 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6365619020
Graduation Year
2003 (23 years ago)
PAC ID
3971560616
Group Practice PAC ID
8628121795
Professional Enrollment ID
I20071106000838
Address ID
MO633672950LA200XXPLZX304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for KATHLEEN KEITHLEY (PA-C)

  • 340, West Lincoln Street, Belleville, Saint Clair County, Illinois, 62220, United States

    BELLEVILLE, IL 622201900

    Phone: (618) 233-6044

    Fax: (618) 233-3287

    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 10 Open Payments records for all available years, with a total value of $275.

Total Amount is formed as General ($275) + Research ($0) + Ownership ($0) = $275.

Last reported payment date: 2024-06-17 • Largest payer in this snapshot: ABBVIE INC. ($195).

Total Amount

$275

General + Research + Ownership

Payments

10

Total payment records

General Amount

$275

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2007-11-06

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
I20071106000838IPhysician AssistantMOTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4742$0
99213Established patient office or other outpatient visit, 20-29 minutes2020$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes1512$0
View full utilization report →

Insurance plans in this area (ZIP 62220)

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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: 8628121795View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineMO
-MO
G A S T R O E N T E R O L O G YNC
General SurgeryMO
G A S T R O E N T E R O L O G YMO
Gastroenterology, Internal MedicineMO
G A S T R O E N T E R O L O G YMO
-MO
Gastroenterology, Internal MedicineMO
G A S T R O E N T E R O L O G YMO

Reviews

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Frequently asked questions

What number should I use to identify KATHLEEN KEITHLEY (PA-C) for billing?
Administrative and clinical systems typically use NPI 1760457352 for KATHLEEN KEITHLEY (PA-C).
Should I treat KATHLEEN KEITHLEY (PA-C) as an active provider?
Patients and plans typically see KATHLEEN KEITHLEY (PA-C) as active in the national extract.
What does the directory say KATHLEEN KEITHLEY (PA-C) does?
Insurance directories may phrase it differently, but here KATHLEEN KEITHLEY (PA-C) maps to Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KATHLEEN KEITHLEY (PA-C)?
KATHLEEN KEITHLEY (PA-C) is associated with Belleville, Illinois in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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