MRS. KELLY MARIE PANTAZO (NP-C) – Family Nurse Practitioner, NPI 1306326855
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,023 NURSE PRACTITIONER in MO
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Provider Addresses for MRS. KELLY MARIE PANTAZO (NP-C)
3647, Kneff Farm Crossing, Imperial Township, Jefferson County, Missouri, 63052, United States
IMPERIAL, MO 630522887
Phone: (314) 882-1978
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)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2021-03-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20181218003254 | I | Nurse Practitioner | MO | TBD |
| I20210309001540 | I | Nurse Practitioner | AR | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 33 | 19 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 63052)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine, Internal Medicine | IL | |
| Emergency Medicine | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| N E U R O L O G Y | AR | |
| Internal Medicine | MO |
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