MRS. KELLIE GOEDKEN DEN HARTOG (PA-C) – Family Medicine Physician, NPI 1992261002
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,649 PHYSICIAN ASSISTANT in IA
Provider Addresses for MRS. KELLIE GOEDKEN DEN HARTOG (PA-C)
800 S. Green Street
Rock Rapids, IA 51246
Phone: (402) 657-0664
Type: Location
1100, South 10th Avenue, Rock Rapids, Lyon County, Iowa, 51246, United States
ROCK RAPIDS, IA 512462020
Phone: (712) 472-5399
Type: Location
1363 HIGHWAY 9 APT 5
LARCHWOOD, IA 512417585
Phone: (712) 348-3341
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2024-03-05 • Largest payer in this snapshot: Abbott Laboratories ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $20 |
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: 2019-05-08
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 |
|---|---|---|---|---|
| I20190508002001 | I | Physician Assistant | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 12 | 11 | $0 |
Insurance plans in this area (ZIP 51246)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IA | |
| - | SD | |
| Internal Medicine, Hospitalist | SD | |
| - | MN | |
| Physical Therapist In Private Practice | SD | |
| - | SD | |
| Diagnostic Radiology | OK | |
| Nurse Practitioner | SD | |
| Nurse Practitioner | SD | |
| Hospice/Palliative Care | SD |
Reviews
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