TYLER J ANTENEN (P.A.-C) – Physician Assistant, NPI 1104377647
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,303 PHYSICIAN ASSISTANT in KS
Provider Addresses for TYLER J ANTENEN (P.A.-C)
750 W D AVE
KINGMAN, KS 670681266
Phone: (620) 532-0295
Fax: (855) 483-0002
Type: Mailing
1719 HIGHWAY 183
PHILLIPSBURG, KS 676612549
Phone: (785) 543-5211
Fax: (785) 543-5274
Type: Mailing
112 N Main St
Cunningham, KS 670358802
Phone: (620) 298-2397
Fax: (855) 290-4906
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $407.
Total Amount is formed as General ($407) + Research ($0) + Ownership ($0) = $407.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Novo Nordisk Inc ($145).
Total Amount
$407
General + Research + Ownership
Payments
25
Total payment records
General Amount
$407
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $145 |
| Amgen Inc. | $70 |
| AstraZeneca Pharmaceuticals LP | $53 |
| Electromed, Inc. | $51 |
| Insulet Corporation | $38 |
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: 2016-11-18
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 |
|---|---|---|---|---|
| I20161118000114 | I | Physician Assistant | KS | 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 67068)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| Family Practice | KS | |
| Nurse Practitioner | KS | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Family Practice | KS | |
| Family Practice | KS | |
| Physician Assistant | KS | |
| Physician Assistant | KS | |
| Nurse Practitioner | KS | |
| Family Practice | KS |
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