LAUREN C KISAN (PA) – Physician Assistant, NPI 1407633894

LAUREN C KISAN (PA) is a healthcare provider. based in Muncie, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for LAUREN C KISAN (PA) is 1407633894

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
LAUREN C KISAN (PA)
NPI
1407633894
Phone
(765) 288-6200
Address
401 W MCGALLIARD RD
Enumeration Date
11 September 2023
Last Update Date
28 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7652886200
Graduation Year
2023 (3 years ago)
PAC ID
6406290477
Group Practice PAC ID
1254306574
Professional Enrollment ID
I20240217000223
Address ID
IN473031828MU401XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

2,499 PHYSICIAN ASSISTANT in IN

Provider Addresses for LAUREN C KISAN (PA)

  • 401 W MCGALLIARD RD

    MUNCIE, IN 473031828

    Phone: (765) 288-6200

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 56 Open Payments records for all available years, with a total value of $1,256.

Total Amount is formed as General ($1,256) + Research ($0) + Ownership ($0) = $1,256.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($348).

Total Amount

$1,256

General + Research + Ownership

Payments

56

Total payment records

General Amount

$1,256

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-02-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240217000223IPhysician AssistantINTBD

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.

Verify on CMS Revalidation Lookup Tool

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 47303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254306574View full group profile
NameSpecialtyState
D E R M A T O L O G YIN
D E R M A T O L O G YIN
D E R M A T O L O G YOH
Micrographic Dermatologic Surgery (Mds), DermatologyOH
Nurse PractitionerIN
D E R M A T O L O G YMI

Reviews

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Frequently asked questions

Can I use this page to confirm LAUREN C KISAN (PA)'s NPI?
Yes. LAUREN C KISAN (PA) is listed with NPI 1407633894 in the public NPI dataset.
Is LAUREN C KISAN (PA) listed as active for patients and plans?
The listing shows LAUREN C KISAN (PA) as active in the NPI system.
What is LAUREN C KISAN (PA)'s primary classification?
Physician Assistant is the headline specialty for LAUREN C KISAN (PA) here. Clinical services aligned with this taxonomy classification.
Where should I expect LAUREN C KISAN (PA) on a map?
Expect Muncie, Indiana as a primary anchor for LAUREN C KISAN (PA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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