KAILEY EVASIC (PA) – Medical Physician Assistant, NPI 1649987488
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for KAILEY EVASIC (PA)
859 WESTBROOKE DR
SOUTH LYON, MI 481781667
Phone: (248) 504-1486
Type: Mailing
55840 GRAND RIVER AVE STE 300
NEW HUDSON, MI 481659717
Phone: (248) 264-6169
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 61 Open Payments records for all available years, with a total value of $1,698.
Total Amount is formed as General ($1,698) + Research ($0) + Ownership ($0) = $1,698.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Pinnacle, Inc ($695).
Total Amount
$1,698
General + Research + Ownership
Payments
61
Total payment records
General Amount
$1,698
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pinnacle, Inc | $695 |
| Arthrex, Inc. | $173 |
| Novo Nordisk Inc | $145 |
| AstraZeneca Pharmaceuticals LP | $130 |
| ABBVIE INC. | $115 |
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: 2023-01-12
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 |
|---|---|---|---|---|
| I20230112001774 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48178)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Nurse Practitioner | ME | |
| Internal Medicine | MI | |
| E N D O C R I N O L O G Y | MI | |
| - | MI | |
| - | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | MI | |
| Internal Medicine | MI |
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