REBECCA ULTCH (PA) – Medical Physician Assistant, NPI 1821054297
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for REBECCA ULTCH (PA)
North Knoxville Avenue, Keller, Peoria, Peoria County, Illinois, 61615, United States
PEORIA, IL 616142085
Phone: (309) 692-9898
Fax: (309) 692-9055
Type: Location
PO BOX 19248
SPRINGFIELD, IL 627949248
Phone: (217) 528-7541
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Endo USA, Inc. ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Endo USA, Inc. | $23 |
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: 2004-02-02
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 |
|---|---|---|---|---|
| I20040202000118 | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 152 | 111 | $0 |
| 81002 | Urinalysis, manual test | 54 | 45 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 49 | 43 | $0 |
| 76775 | Limited ultrasound scan behind abdominal cavity | 29 | 24 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 25 | 25 | $0 |
Insurance plans in this area (ZIP 61614)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | TX | |
| Family Practice, Colorectal Surgery (Proctology) | NC | |
| - | IL |
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