CHEREKA SHANTAE KLUTTZ (D.O.) – Family Medicine Physician, NPI 1053691279
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CHEREKA SHANTAE KLUTTZ (D.O.)
456 COACHGATE CT
BALLWIN, MO 630218853
Phone:
Type: Mailing
250 2ND ST E STE 4E
BRADENTON, FL 342081028
Phone: (941) 745-7251
Type: Location
2345 DOUGHERTY FERRY RD
SAINT LOUIS, MO 631223313
Phone: (314) 966-9491
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $355.
Total Amount is formed as General ($355) + Research ($0) + Ownership ($0) = $355.
Last reported payment date: 2024-09-12 • Largest payer in this snapshot: Organogenesis Inc. ($208).
Total Amount
$355
General + Research + Ownership
Payments
10
Total payment records
General Amount
$355
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $208 |
| Smith+Nephew, Inc. | $133 |
| Hydrofera LLC | $14 |
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: 2022-08-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1042 days ago).
Enrollment records
2
Earliest due date
2023-07-31
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 |
|---|---|---|---|---|
| I20140722002628 | I | Family Practice | MO | 2023-07-31 |
| I20220818001952 | I | Family Practice | FL | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 68 | 24 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 35 | 18 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 21 | 15 | $0 |
Insurance plans in this area (ZIP 63021)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Emergency Medicine | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| Family Practice | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO |
Reviews
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