TRISTAN JOSEPH MCKENNA (DO) – Family Medicine Physician, NPI 1417304403
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,259 FAMILY PRACTICE in AZ
Provider Addresses for TRISTAN JOSEPH MCKENNA (DO)
1967, Moyer Drive, Green Valley, Henderson, Clark County, Nevada, 89074, United States
HENDERSON, NV 890741033
Phone:
Type: Mailing
3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone: (928) 757-2101
Type: Location
Stockton Hill Road, Kingman, Mohave County, Arizona, 86409, United States
KINGMAN, AZ 86409
Phone: (928) 757-2101
Type: Location
PO BOX 1475
DES MOINES, IA 503051475
Phone: (515) 643-7100
Fax: (515) 643-7145
Type: Mailing
2605 SW WHITE BIRCH DR
ANKENY, IA 500237204
Phone: (515) 643-7100
Fax: (515) 643-7145
Type: Location
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: 2021-07-30
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 |
|---|---|---|---|---|
| I20210730000574 | I | Family Practice | IA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 465 | 265 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 122 | 92 | $0 |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 102 | 84 | $0 |
| 98927 | Osteopathic manipulative treatment, 5-6 body regions | 91 | 23 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 62 | 62 | $0 |
Insurance plans in this area (ZIP 89074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | IA | |
| P S Y C H I A T R Y | IA | |
| - | IA | |
| Family Practice | IA | |
| - | NE | |
| Emergency Medicine | IA | |
| Family Practice | IA | |
| Physician Assistant | IA | |
| - | IA | |
| Nurse Practitioner | IA |
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