ELTON G. FENNELL (M.D.) – Obstetrics & Gynecology Physician, NPI 1497705891
Obstetrics & Gynecology Physician
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NPPES metrics only — not quality of care.
962 OBSTETRICS/GYNECOLOGY in IN
Provider Addresses for ELTON G. FENNELL (M.D.)
420 N Sawyer Rd
Kendallville, IN 467552572
Phone: (260) 347-8030
Fax: (260) 347-8035
Type: Location
3400 E Racine St
Janesville, WI 535462344
Phone: (608) 373-8000
Fax: (608) 371-8928
Type: Location
Evansville Post office, 402, Water Street, Evansville, Rock County, Wisconsin, 53536, United States
EVANSVILLE, IN 477333407
Phone: (812) 450-3363
Fax: (812) 450-3071
Type: Mailing
415, West Columbia Street, Evansville, Vanderburgh County, Indiana, 47710, United States
STE 110
EVANSVILLE, IN 477101656
Phone: (812) 450-3363
Fax: (812) 450-3071
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: 2021-03-03
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 |
|---|---|---|---|---|
| I20050602000152 | I | Obstetrics/Gynecology | MN | TBD |
| I20050929000686 | I | Obstetrics/Gynecology | WI | TBD |
| I20081010000243 | I | Obstetrics/Gynecology | MA | TBD |
| I20210303003431 | I | Obstetrics/Gynecology | 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 46755)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | WA | |
| - | WI | |
| O P T O M E T R Y | WI | |
| N E U R O S U R G E R Y | NE | |
| - | WI | |
| Physician Assistant | WI | |
| Family Practice | WI | |
| Cardiovascular Disease (Cardiology) | TX | |
| - | WI | |
| Family Practice | WI |
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