ALYSSA L KOZACEK (D.O.) – Family Medicine Physician, NPI 1174100895
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,718 FAMILY PRACTICE in KY
Provider Addresses for ALYSSA L KOZACEK (D.O.)
PO BOX 1080
BURKESVILLE, KY 427171080
Phone: (270) 858-6655
Fax: (270) 858-4027
Type: Mailing
404 STEVE DRIVE
RUSSELL SPRINGS, KY 426424622
Phone: (270) 866-3161
Fax: (270) 866-3163
Type: Location
182 JACKSON LN
SOMERSET, KY 425014951
Phone:
Type: Mailing
350 HOSPITAL WAY
SOMERSET, KY 425032872
Phone: (606) 451-2624
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $96.
Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Xeris Pharmaceuticals, Inc. ($24).
Total Amount
$96
General + Research + Ownership
Payments
5
Total payment records
General Amount
$96
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Xeris Pharmaceuticals, Inc. | $24 |
| Seqirus USA Inc | $21 |
| AstraZeneca Pharmaceuticals LP | $19 |
| ABBVIE INC. | $17 |
| Exact Sciences Corporation | $16 |
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: 2024-09-05
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 |
|---|---|---|---|---|
| I20240905002147 | I | Family Practice | KY | 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 42717)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Certified Nurse Midwife (Cnm) | KY | |
| Clinical Social Worker | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY | |
| Certified Nurse Midwife (Cnm) | KY | |
| Nurse Practitioner | KY |
Reviews
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