MRS. KELLY MCINTOSH (PA-C) – Physician Assistant, NPI 1023235520
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for MRS. KELLY MCINTOSH (PA-C)
2333 BIDDLE ST
WYANDOTTE, MI 481924668
Phone: (734) 246-6966
Fax: (734) 287-9727
Type: Location
324 N HARVEY ST
PLYMOUTH, MI 481701223
Phone:
Type: Mailing
6777 W MAPLE RD
WEST BLOOMFIELD, MI 483223013
Phone: (248) 325-1000
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: 2004-07-06
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 |
|---|---|---|---|---|
| I20040706000885 | I | Physician Assistant | MI | 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 | 12 | 12 | $0 |
Insurance plans in this area (ZIP 48192)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
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