GAUTAM KUKREJA (MD) – Pediatrics Physician, NPI 1205151198
Pediatrics Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
273 PEDIATRIC MEDICINE in IA
Provider Addresses for GAUTAM KUKREJA (MD)
3200 W KIMBERLY RD
DAVENPORT, IA 528063059
Phone: (563) 421-0010
Fax: (563) 421-0009
Type: Location
500 W River Dr
Davenport, IA 528011014
Phone: (563) 336-3000
Fax: (563) 336-3125
Type: Location
Community Health Care, 500, West River Drive, Davenport, Scott County, Iowa, 52801, United States
DAVENPORT, IA 528011014
Phone: (563) 336-3000
Fax: (563) 336-3125
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $95.
Total Amount is formed as General ($95) + Research ($0) + Ownership ($0) = $95.
Last reported payment date: 2024-06-11 • Largest payer in this snapshot: PFIZER INC. ($43).
Total Amount
$95
General + Research + Ownership
Payments
6
Total payment records
General Amount
$95
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $43 |
| SANOFI PASTEUR INC. | $19 |
| VERRICA PHARMACEUTICALS INC. | $17 |
| GlaxoSmithKline, LLC. | $16 |
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: 2010-07-27
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20100727000124 | I | Pediatric Medicine | IA | 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 52806)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IA | |
| - | IA | |
| Nurse Practitioner | IA | |
| P S Y C H I A T R Y | IA | |
| - | IA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Family Practice | IA | |
| - | IA | |
| - | IA | |
| Clinical Social Worker | IA |
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