KELLY D CHAVEZ (PA-C) – Physician Assistant, NPI 1356329379
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,685 PHYSICIAN ASSISTANT in AZ
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Provider Addresses for KELLY D CHAVEZ (PA-C)
2285, Corporate Circle, Green Valley Ranch, Henderson, Clark County, Nevada, 89074, United States
STE 200
HENDERSON, NV 890747759
Phone: (702) 360-2763
Fax: (949) 783-2880
Type: Mailing
1729, North Trekell Road, Casa Grande, Pinal County, Arizona, 85122, United States
SUITE 124
CASA GRANDE, AZ 85222
Phone: (520) 421-7100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $576.
Total Amount is formed as General ($576) + Research ($0) + Ownership ($0) = $576.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($139).
Total Amount
$576
General + Research + Ownership
Payments
22
Total payment records
General Amount
$576
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2011-10-11
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 |
|---|---|---|---|---|
| I20111011000698 | I | Physician Assistant | AZ | 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 | 6,827 | 695 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,234 | 735 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 954 | 696 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 848 | 597 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 286 | 185 | $0 |
Insurance plans in this area (ZIP 89074)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | AZ | 11101 | Biopsy of each additional growth of skin and/or tissue | 29 | 26 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds), General Practice | FL | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Family Practice, Dermatology | AZ | |
| D E R M A T O L O G Y | AZ | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | AZ | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | AZ | |
| Nurse Practitioner | AZ |
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