DR. KRISTIAN ASHTIN DE NAGEL (MD) – Sports Medicine (Family Medicine) Physician, NPI 1922634039
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
144 SPORTS MEDICINE in MO
Provider Addresses for DR. KRISTIAN ASHTIN DE NAGEL (MD)
PO BOX 776351
CHICAGO, IL 606776351
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
600 NW MURRAY RD STE 201
LEES SUMMIT, MO 640811227
Phone: (816) 524-2626
Type: Location
210 E Gray St Ste 604
Louisville, KY 402023902
Phone: (502) 629-5633
Fax: (502) 629-5580
Type: Location
1125 N COLLEGE AVE
FAYETTEVILLE, AR 727031908
Phone: (479) 521-8260
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 $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Dynavax Technologies Corporation ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
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 |
|---|---|
| Dynavax Technologies Corporation | $19 |
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: 2025-12-30
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 |
|---|---|---|---|---|
| I20251230002912 | I | Sports Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60677)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Orthopedic Surgery | IN | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | IL | |
| Family Practice | IL | |
| Nurse Practitioner | KY | |
| - | IL | |
| Internal Medicine | KY | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
Reviews
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