MR. KEVIN YAN KOENDERS (PA-C) – Surgical Physician Assistant, NPI 1003473273
Surgical Physician Assistant
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NPPES metrics only — not quality of care.
5,093 PHYSICIAN ASSISTANT in MA
Provider Addresses for MR. KEVIN YAN KOENDERS (PA-C)
780 Albany St
Boston, MA 021182755
Phone: (857) 654-1000
Type: Location
2000;2002;2004;2010;2101;2102;2103;2104;2107;2108;2109;2110;2201;2202;2204;2207;2208;2209;2210;2301;2302;2303;2304;2306;2307;2308;2309;2310, Avalon Drive, Northborough, Worcester County, Massachusetts, 01581, United States
NORTHBOROUGH, MA 015322373
Phone:
Type: Mailing
119 Belmont St
Worcester, MA 016052903
Phone: (508) 334-8515
Fax: (508) 334-6490
Type: Location
2650 Ridge Ave
Evanston, IL 602011700
Phone: (847) 570-2112
Fax: (847) 570-1041
Type: Location
55 Lake Ave N
Worcester, MA 016550002
Phone: (508) 334-8515
Fax: (508) 334-6490
Type: Location
1200 S York St Ste 2000
Elmhurst, IL 601265634
Phone: (331) 221-9004
Fax: (331) 221-2748
Type: Location
Newton-Wellesley Hospital, 2014, Washington Street, Newton Lower Falls, Newton, Middlesex County, Massachusetts, 02462, United States
DEPARTMENT OF ORTHOPEDICS
NEWTON, MA 024621607
Phone: (617) 219-1674
Type: Location
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Fax: (508) 334-1977
Type: Mailing
1200 S YORK ST STE 2000
ELMHURST, IL 601265634
Phone: (331) 221-9004
Fax: (331) 221-2748
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-10-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20201102002044 | I | Physician Assistant | MA | TBD |
| I20241022001650 | I | Physician Assistant | IL | 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 |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 14 | 14 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 11 | 11 | $0 |
Insurance plans in this area (ZIP 02118)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| N E U R O L O G Y | IL | |
| Hospitalist, Internal Medicine | IL | |
| O P H T H A L M O L O G Y | IL | |
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| Clinical Social Worker | IL | |
| Certified Nurse Midwife (Cnm) | IL | |
| Rheumatology, Internal Medicine | IL |
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