CRISTINA ELIZABET HERMOSILLO (PA-C) – Medical Physician Assistant, NPI 1104607738
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for CRISTINA ELIZABET HERMOSILLO (PA-C)
8003 CASTLEWAY DR
INDIANAPOLIS, IN 462501946
Phone: (317) 576-1335
Fax: (317) 343-6562
Type: Mailing
3118 S LAFOUNTAIN ST
KOKOMO, IN 469023710
Phone: (765) 864-4160
Fax: (765) 400-4467
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $211.
Total Amount is formed as General ($211) + Research ($0) + Ownership ($0) = $211.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Lilly USA, LLC ($69).
Total Amount
$211
General + Research + Ownership
Payments
12
Total payment records
General Amount
$211
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-01-29
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 |
|---|---|---|---|---|
| I20240129001761 | I | Physician Assistant | IN | 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 46250)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| Mental Health Counselor | IN | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| Nurse Practitioner | IN | |
| C H I R O P R A C T I C | MO | |
| Nurse Practitioner | IN | |
| Physician Assistant | IN | |
| Family Practice | IN | |
| Nurse Practitioner | MI |
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