MR. TIMOTHY C STALLARD (PA) – Surgical Physician Assistant, NPI 1679536148
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,303 PHYSICIAN ASSISTANT in KS
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Provider Addresses for MR. TIMOTHY C STALLARD (PA)
23401 PRAIRIE STAR PKWY STE B300
LENEXA, KS 662277268
Phone: (913) 677-6319
Fax: (913) 677-1540
Type: Mailing
Shawnee Mission Health, 23401, Prairie Star Parkway, Lenexa, Johnson County, Kansas, 66204, United States
SUITE 300
LENEXA, KS 662277268
Phone: (913) 677-6319
Fax: (913) 677-1540
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $58.
Total Amount is formed as General ($58) + Research ($0) + Ownership ($0) = $58.
Last reported payment date: 2023-09-14 • Largest payer in this snapshot: Ethicon US, LLC ($58).
Total Amount
$58
General + Research + Ownership
Payments
2
Total payment records
General Amount
$58
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ethicon US, LLC | $58 |
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: 2005-04-22
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 |
|---|---|---|---|---|
| I20050422000964 | 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 66227)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| General Surgery | KS | |
| Physical Therapist In Private Practice | KS | |
| Nurse Practitioner | MO | |
| Clinical Psychologist | KS | |
| - | CO | |
| General Surgery | KS | |
| Physical Therapist In Private Practice | MO | |
| Clinical Psychologist | KS | |
| Physician Assistant | MO |
Reviews
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