MRS. KIMBERLY K PROVOAST (PA) – Physician Assistant, NPI 1770899551
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for MRS. KIMBERLY K PROVOAST (PA)
337 E HOUGHTON AVE
WEST BRANCH, MI 486611127
Phone: (989) 345-5240
Fax: (989) 345-4513
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 9 Open Payments records for all available years, with a total value of $145.
Total Amount is formed as General ($145) + Research ($0) + Ownership ($0) = $145.
Last reported payment date: 2024-02-12 • Largest payer in this snapshot: PFIZER INC. ($43).
Total Amount
$145
General + Research + Ownership
Payments
9
Total payment records
General Amount
$145
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-12
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: 2011-04-07
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 |
|---|---|---|---|---|
| I20110407000241 | 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 48661)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MI | 83036 | Hemoglobin A1C level | 93 | 66 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | MI | |
| Orthopedic Surgery | MI | |
| Nurse Practitioner | MI | |
| Sports Medicine | PA | |
| Physical Therapist In Private Practice | MI | |
| Orthopedic Surgery | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI |
Reviews
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