JUDY KY (PAC) – Physician Assistant, NPI 1942309463
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,853 PHYSICIAN ASSISTANT in MO
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Provider Addresses for JUDY KY (PAC)
3265, Northeast Ralph Powell Road, Chapel Ridge Business Park, Lee's Summit, Jackson County, Missouri, 64064, United States
LEES SUMMIT, MO 640642301
Phone: (913) 451-7546
Fax: (816) 875-1894
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 130 Open Payments records for all available years, with a total value of $2,676.
Total Amount is formed as General ($2,676) + Research ($0) + Ownership ($0) = $2,676.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($572).
Total Amount
$2,676
General + Research + Ownership
Payments
130
Total payment records
General Amount
$2,676
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $572 |
| ABBVIE INC. | $489 |
| Arcutis Biotherapeutics, Inc. | $366 |
| Dermavant Sciences, Inc. | $313 |
| Lilly USA, LLC | $157 |
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: 2014-05-21
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 |
|---|---|---|---|---|
| I20041228000642 | I | Physician Assistant | KS | TBD |
| I20140521000712 | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 591 | 132 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 344 | 242 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 278 | 195 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 185 | 160 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 136 | 136 | $0 |
Insurance plans in this area (ZIP 64064)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KS | |
| Nurse Practitioner | KS | |
| D E R M A T O L O G Y | KS | |
| Nurse Practitioner | MO | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | MO | |
| - | KS | |
| Physician Assistant | KS | |
| Physician Assistant | MO | |
| Physician Assistant | MO | |
| D E R M A T O L O G Y | MO |
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