KELLIE A LASKOWSKI (PA C) – Physician Assistant, NPI 1770574634

KELLIE A LASKOWSKI (PA C) is a healthcare provider. based in Muskegon, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA C. They hold a License No. 5601003618 (MI). The NPI Number for KELLIE A LASKOWSKI (PA C) is 1770574634

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE A LASKOWSKI (PA C)
NPI
1770574634
Phone
(231) 737-8446
Address
1325 E SHERMAN BLVD
Enumeration Date
31 October 2005
Last Update Date
7 February 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2317378446
Graduation Year
2001 (25 years ago)
PAC ID
0547232704
Group Practice PAC ID
0547226433
Professional Enrollment ID
I20040809000605
Address ID
MI494441813NO1325XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for KELLIE A LASKOWSKI (PA C)

  • 1325, East Sherman Boulevard, Norton Shores, Muskegon Township, Muskegon County, Michigan, 49444, United States

    MUSKEGON, MI 494441813

    Phone: (231) 737-8446

    Fax: (231) 737-0510

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $41.

Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.

Last reported payment date: 2024-09-30 • Largest payer in this snapshot: Baxter Healthcare ($27).

Total Amount

$41

General + Research + Ownership

Payments

3

Total payment records

General Amount

$41

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-08-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040809000605IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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 49444)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547226433View full group profile
NameSpecialtyState
-MI
P S Y C H I A T R YMI
Physician AssistantMI
General SurgeryMI
Physician AssistantMI

Reviews

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Frequently asked questions

Can I use this page to confirm KELLIE A LASKOWSKI (PA C)'s NPI?
Yes. KELLIE A LASKOWSKI (PA C) is listed with NPI 1770574634 in the public NPI dataset.
Does the file indicate KELLIE A LASKOWSKI (PA C) is practicing under active NPI?
Directory data currently reports KELLIE A LASKOWSKI (PA C) as active.
What healthcare role does KELLIE A LASKOWSKI (PA C) hold?
Scheduling teams often label KELLIE A LASKOWSKI (PA C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is KELLIE A LASKOWSKI (PA C) based?
KELLIE A LASKOWSKI (PA C) is tied to Muskegon, Michigan in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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