WALTER M KIDWELL (MD) – Interventional Pain Medicine Physician, NPI 1215977038
Interventional Pain Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
102 PAIN MANAGEMENT in NV
Provider Addresses for WALTER M KIDWELL (MD)
600 S Rancho Dr
Suite 113
Las Vegas, NV 89106
Phone: (702) 878-8252
Fax: (702) 878-9096
Type: Location
7065 W Ann Rd Ste 130-548
Las Vegas, NV 891303865
Phone: (702) 878-8252
Fax: (702) 878-9096
Type: Location
Cloud Tea, 4045, South Buffalo Drive, Las Vegas, Clark County, Nevada, 89147, United States
A101-172
LAS VEGAS, NV 891477479
Phone: (702) 878-8252
Fax: (702) 878-9096
Type: Mailing
7435 W AZURE DR STE 190
LAS VEGAS, NV 891304427
Phone: (702) 788-5252
Fax: (702) 878-9096
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2023-07-25 • Largest payer in this snapshot: Boston Scientific Corporation ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $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: 2007-07-26
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 |
|---|---|---|---|---|
| I20070726000865 | I | Pain Management | UT | 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 |
|---|---|---|---|---|
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 15 | 12 | $0 |
Insurance plans in this area (ZIP 89106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | NV | |
| Certified Registered Nurse Anesthetist (Crna) | NM | |
| Certified Registered Nurse Anesthetist (Crna) | SD | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT | |
| Certified Registered Nurse Anesthetist (Crna) | AZ | |
| Certified Registered Nurse Anesthetist (Crna) | NV | |
| Certified Registered Nurse Anesthetist (Crna) | NE |
Reviews
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