KODI M BONE (PA-C) – Physician Assistant, NPI 1184886012
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for KODI M BONE (PA-C)
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone: (616) 486-6790
Fax: (907) 580-6444
Type: Mailing
7 ATKINSON DR STE 115
LUDINGTON, MI 494311953
Phone: (231) 845-2270
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 208 Open Payments records for all available years, with a total value of $4,452.
Total Amount is formed as General ($4,452) + Research ($0) + Ownership ($0) = $4,452.
Last reported payment date: 2024-12-27 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($329).
Total Amount
$4,452
General + Research + Ownership
Payments
208
Total payment records
General Amount
$4,452
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-27
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2019-01-24
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 |
|---|---|---|---|---|
| I20190124002419 | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 100 | 50 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 90 | 49 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 71 | 54 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 55 | 55 | $0 |
| 83540 | Iron level | 48 | 28 | $0 |
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Medical Oncology | MI | |
| Nurse Practitioner | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| H E M A T O L O G Y/ O N C O L O G Y | MI |
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