MRS. CANDACE NICHOLE EMMENDORFER (PA-C) – Physician Assistant, NPI 1831392620
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,853 PHYSICIAN ASSISTANT in MO
Provider Addresses for MRS. CANDACE NICHOLE EMMENDORFER (PA-C)
469, Whetstone Way, Jackson, Cape Girardeau County, Missouri, 63755, United States
JACKSON, MO 637553052
Phone: (573) 528-0478
Type: Mailing
PO BOX 801143
KANSAS CITY, MO 641801143
Phone: (573) 331-5583
Fax: (573) 331-5079
Type: Mailing
48 DOCTORS PARK
CAPE GIRARDEAU, MO 637034928
Phone: (573) 335-8257
Fax: (573) 335-8424
Type: Location
1723, Broadway Street, Cape Girardeau, Cape Girardeau County, Missouri, 63701, United States
SUITE 410
CAPE GIRARDEAU, MO 637014566
Phone: (573) 332-7746
Fax: (573) 339-9709
Type: Location
70 DOCTORS PARK
CAPE GIRARDEAU, MO 637034928
Phone: (573) 335-6671
Fax: (573) 331-5079
Type: Mailing
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: 2013-05-29
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 |
|---|---|---|---|---|
| I20130529000148 | I | Physician Assistant | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 508 | 134 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 92 | 79 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 84 | 68 | $0 |
| 73130 | X-ray of hand, minimum of 3 views | 75 | 59 | $0 |
| 20550 | Injection into tendon or ligament | 68 | 46 | $0 |
Insurance plans in this area (ZIP 63755)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | TN | |
| Diagnostic Radiology | MO | |
| Diagnostic Radiology | MO | |
| Diagnostic Radiology | MO | |
| Physician Assistant | MO | |
| Diagnostic Radiology | MO | |
| Diagnostic Radiology, Interventional Radiology | KS | |
| Interventional Radiology, Diagnostic Radiology | MO | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MO |
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