JAN HENDRICKSON – Physician Assistant, NPI 1811520802
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,396 PHYSICIAN ASSISTANT in NE
Provider Addresses for JAN HENDRICKSON
1835 COUNTRY CLUB DR
MARION, IA 523025517
Phone: (319) 210-9930
Type: Mailing
2412 CUMING ST
OMAHA, NE 681311601
Phone: (402) 717-0380
Type: Location
3200 GRAND AVE
DES MOINES, IA 503124104
Phone: (515) 271-1569
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $399.
Total Amount is formed as General ($399) + Research ($0) + Ownership ($0) = $399.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ViiV Healthcare Company ($174).
Total Amount
$399
General + Research + Ownership
Payments
23
Total payment records
General Amount
$399
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
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: 2022-10-05
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 |
|---|---|---|---|---|
| I20221005001484 | I | Physician Assistant | NE | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 17 | 16 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 13 | 11 | $0 |
Insurance plans in this area (ZIP 52302)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H O S P I T A L I S T | NE | |
| Orthopedic Surgery | NE | |
| Physician Assistant | NE | |
| Cardiovascular Disease (Cardiology) | NE | |
| H O S P I T A L I S T | CA | |
| N E U R O L O G Y | MO | |
| U R O L O G Y | NE | |
| Hospitalist, Internal Medicine | IA | |
| Family Practice | NE | |
| Orthopedic Surgery | IL |
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