MIKE STAFF (PA) – Physician Assistant, NPI 1326104290
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 MIKE STAFF (PA)
Andrew Jacobs Jr. Post Office, 125, West South Street, Old Southside, Indianapolis, Marion County, Indiana, 46206, United States
INDIANAPOLIS, IN 462061105
Phone: (618) 549-5361
Fax: (618) 549-5128
Type: Mailing
2601, West Main Street, Carbondale, Jackson County, Illinois, 62901, United States
CARBONDALE, IL 629011031
Phone: (618) 549-5361
Fax: (618) 549-5128
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $332.
Total Amount is formed as General ($332) + Research ($0) + Ownership ($0) = $332.
Last reported payment date: 2024-11-04 • Largest payer in this snapshot: Novo Nordisk Inc ($108).
Total Amount
$332
General + Research + Ownership
Payments
19
Total payment records
General Amount
$332
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-04
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: 2003-12-18
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 |
|---|---|---|---|---|
| I20031218000721 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46206)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Registered Dietitian Or Nutrition Professional | IL | |
| Nurse Practitioner | IL | |
| Critical Care (Intensivists), Internal Medicine | LA | |
| Nurse Practitioner | IL | |
| Internal Medicine | IL | |
| General Surgery | CA | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
Reviews
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