DR. TOM KETTLER (M.D.) – Family Medicine Physician, NPI 1285621615
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,421 FAMILY PRACTICE in KS
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Provider Addresses for DR. TOM KETTLER (M.D.)
15101, Glenwood Avenue, Blue Valley Hills, Stanley, Overland Park, Johnson County, Kansas, 66223, United States
STANLEY, KS 662233154
Phone: (913) 681-8866
Fax: (913) 338-1311
Type: Location
PO BOX 741331
ATLANTA, GA 303741331
Phone: (913) 469-0503
Fax: (913) 469-5267
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 95 Open Payments records for all available years, with a total value of $1,803.
Total Amount is formed as General ($1,803) + Research ($0) + Ownership ($0) = $1,803.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Lilly USA, LLC ($244).
Total Amount
$1,803
General + Research + Ownership
Payments
95
Total payment records
General Amount
$1,803
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $244 |
| Novo Nordisk Inc | $240 |
| ABBVIE INC. | $225 |
| Boston Scientific Corporation | $191 |
| IDORSIA PHARMACEUTICALS US INC | $135 |
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: 2010-05-18
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 |
|---|---|---|---|---|
| I20100518000748 | I | Family Practice | 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.
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 | 175 | 128 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 106 | 106 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 101 | 67 | $0 |
| 71046 | X-ray of chest, 2 views | 17 | 15 | $0 |
| 77067 | Screening mammography | 16 | 16 | $0 |
Insurance plans in this area (ZIP 66223)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | KS | 90670 | Pneumococcal vaccine for injection into muscle | 16 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| - | CO | |
| Family Practice, Anesthesiology | GA | |
| General Surgery | MO | |
| Physician Assistant | KS | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KS | |
| Family Practice | GA |
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