KELLY PEREZ (PAC) – Physician Assistant, NPI 1376629493
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for KELLY PEREZ (PAC)
15100 WHITTAKER WAY
GRAND HAVEN, MI 494178696
Phone: (616) 935-6210
Type: Location
Muskegon General Hospital, 1700, Oak Avenue, Shady Park Neighbourhood, Muskegon, Muskegon Township, Muskegon County, Michigan, 49444, United States
MUSKEGON, MI 494422407
Phone: (231) 672-6580
Fax: (231) 672-6256
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $96.
Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.
Last reported payment date: 2024-04-05 • Largest payer in this snapshot: Pharmacyclics LLC, an AbbVie Company ($62).
Total Amount
$96
General + Research + Ownership
Payments
4
Total payment records
General Amount
$96
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-05
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: 2024-05-01
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 |
|---|---|---|---|---|
| I20040722000202 | I | Physician Assistant | MI | TBD |
| I20240501002198 | I | Physician Assistant | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49417)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| Interventional Radiology | MI | |
| Cardiovascular Disease (Cardiology) | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI |
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