MICHELLE KAY BANK (AGNP-C) – Gerontology Nurse Practitioner, NPI 1174094072
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
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Provider Addresses for MICHELLE KAY BANK (AGNP-C)
12409, Roth Hill Drive, Dawn Valley, Maryland Heights, Saint Louis County, Missouri, 63043, United States
MARYLAND HEIGHTS, MO 630432941
Phone: (636) 299-3632
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 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: 2024-09-10 • Largest payer in this snapshot: Braeburn Inc. ($55).
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
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Braeburn Inc. | $55 |
| Alkermes, Inc. | $23 |
| Janssen Pharmaceuticals, Inc | $18 |
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: 2023-07-24
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 |
|---|---|---|---|---|
| I20230724002162 | I | Nurse Practitioner | MO | 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 63043)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| C H I R O P R A C T I C | MO | |
| - | MO | |
| Family Practice | MO | |
| O P T O M E T R Y | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Clinical Social Worker | MO | |
| - | MO | |
| O P T O M E T R Y | MO | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO |
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