MR. KRISTIAN HALE JENSEN (PAC) – Physician Assistant, NPI 1942209184
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
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Provider Addresses for MR. KRISTIAN HALE JENSEN (PAC)
679, County Line Road, Phoenix, Greenwood County, South Carolina, 29819, United States
GREENWOOD, IN 461431049
Phone: (317) 807-1266
Fax: (317) 859-4269
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 53 Open Payments records for all available years, with a total value of $1,270.
Total Amount is formed as General ($1,270) + Research ($0) + Ownership ($0) = $1,270.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Boston Scientific Corporation ($182).
Total Amount
$1,270
General + Research + Ownership
Payments
53
Total payment records
General Amount
$1,270
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
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: 2020-07-21
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 |
|---|---|---|---|---|
| I20200721000679 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 353 | 157 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 102 | 91 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 89 | 22 | $0 |
| 84403 | Testosterone (hormone) level, total | 74 | 47 | $0 |
| 84270 | Sex hormone binding globulin (protein) level | 73 | 47 | $0 |
Insurance plans in this area (ZIP 46143)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Interventional Radiology | IN | |
| - | IN | |
| Nurse Practitioner | IL | |
| U R O L O G Y | IN | |
| U R O L O G Y | IN | |
| P A T H O L O G Y | AR | |
| Nurse Practitioner | IN | |
| - | IN | |
| U R O L O G Y | IN |
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