JACOB KALLIATH (D.O.) – Internal Medicine Physician, NPI 1134569395
Internal Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,511 INTERNAL MEDICINE in IN
Provider Addresses for JACOB KALLIATH (D.O.)
4455 Edison Lakes Pkwy
Mishawaka, IN 465451442
Phone: (574) 231-6134
Fax: (574) 231-6845
Type: Location
10624 S. EASTERN AVE #263A
HENDERSON, NV 89052
Phone: (760) 684-0407
Fax: (800) 604-6214
Type: Mailing
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Phone: (708) 679-2160
Fax: (708) 679-2161
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2022-07-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20160728000009 | I | Internal Medicine | IL | TBD |
| I20170119002900 | I | Internal Medicine | WI | TBD |
| I20170209000508 | I | Internal Medicine | WA | TBD |
| I20220721003387 | I | Internal Medicine | AZ | 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 |
|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 164 | 96 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 151 | 135 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 138 | 78 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 102 | 98 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 71 | 26 | $0 |
Insurance plans in this area (ZIP 46545)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Hospitalist, Family Practice | MN | |
| Family Practice | KS | |
| Diagnostic Radiology | MN | |
| Physician Assistant | WA | |
| Hospitalist, Family Practice | NV | |
| Physician Assistant | WA | |
| General Surgery | MN | |
| Physician Assistant | WA | |
| Diagnostic Radiology | MN |
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