KELLYANN O'BRIEN (PA-C) – Medical Physician Assistant, NPI 1619910155
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
Provider Addresses for KELLYANN O'BRIEN (PA-C)
471 Center St
Ludlow, MA 010562733
Phone: (413) 625-3500
Type: Location
280, Chestnut Street, Metro Center, Springfield, Hampden County, Massachusetts, 01103, United States
2ND FLOOR
SPRINGFIELD, MA 011991619
Phone: (413) 794-5700
Type: Mailing
3400, Main Street, North End, Springfield, Hampden County, Massachusetts, 01107, United States
SPRINGFIELD, MA 011071113
Phone: (413) 794-9560
Fax: (413) 794-5884
Type: Location
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: 2016-07-14
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 |
|---|---|---|---|---|
| I20160714002066 | I | Physician Assistant | MA | 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 |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 22 | 22 | $0 |
Insurance plans in this area (ZIP 01056)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | ME | |
| Physician Assistant | NH | |
| Physician Assistant | NH | |
| Physician Assistant | NH | |
| Nurse Practitioner | NH | |
| Physician Assistant | MA | |
| Emergency Medicine | CA | |
| Physician Assistant | MA | |
| Physician Assistant | MA | |
| Physician Assistant | MA |
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