MRS. STEPHANIE M ELLIS (PA) – Physician Assistant, NPI 1922313238
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MRS. STEPHANIE M ELLIS (PA)
4909 N GLEN PARK PLACE RD
PEORIA, IL 616144676
Phone: (309) 674-7546
Fax: (309) 282-0500
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $445.
Total Amount is formed as General ($445) + Research ($0) + Ownership ($0) = $445.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($166).
Total Amount
$445
General + Research + Ownership
Payments
15
Total payment records
General Amount
$445
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $166 |
| Novartis Pharmaceuticals Corporation | $58 |
| GENZYME CORPORATION | $52 |
| ABBVIE INC. | $36 |
| PFIZER INC. | $25 |
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: 2025-07-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20101111000649 | I | Physician Assistant | IL | TBD |
| I20250702001903 | I | Physician Assistant | MO | 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 | 766 | 163 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 408 | 348 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 274 | 239 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 197 | 175 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 162 | 162 | $0 |
Insurance plans in this area (ZIP 61614)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 17003 | Destruction of 2-14 skin growths | 1986 | 335 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| D E R M A T O L O G Y | MO | |
| Physician Assistant | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.