KATHRYN MARIE POULOS – Physician Assistant, NPI 1083988323
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for KATHRYN MARIE POULOS
9377 N HAGGERTY RD
PLYMOUTH, MI 481704622
Phone: (734) 451-0070
Fax: (734) 451-1583
Type: Mailing
22301 Kelly Rd
Eastpointe, MI 480212619
Phone: (586) 443-5588
Fax: (586) 443-5538
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 64 Open Payments records for all available years, with a total value of $1,254.
Total Amount is formed as General ($1,254) + Research ($0) + Ownership ($0) = $1,254.
Last reported payment date: 2024-09-27 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($328).
Total Amount
$1,254
General + Research + Ownership
Payments
64
Total payment records
General Amount
$1,254
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $328 |
| GlaxoSmithKline, LLC. | $161 |
| ABBVIE INC. | $80 |
| PFIZER INC. | $76 |
| Lundbeck LLC | $70 |
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: 2012-04-17
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 |
|---|---|---|---|---|
| I20120417000771 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 101 | 54 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 72 | 44 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 62 | 16 | $0 |
| 99441 | Telephone medical discussion with physician, 5-10 minutes | 31 | 23 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 25 | 25 | $0 |
Insurance plans in this area (ZIP 48170)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| Physician Assistant | MI |
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