MICHAEL KEITH MIETZ (PA) – Medical Physician Assistant, NPI 1689944779
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,244 PHYSICIAN ASSISTANT in NY
Provider Addresses for MICHAEL KEITH MIETZ (PA)
120 HOBART ST
UTICA, NY 135014308
Phone: (315) 798-1149
Fax: (315) 734-3565
Type: Mailing
14440 Olympic Drive
Clearlake, CA 954228809
Phone: (707) 263-8383
Fax: (707) 263-5019
Type: Location
925 BEVINS COURT
LAKEPORT, CA 954539754
Phone: (707) 263-8383
Fax: (707) 263-5019
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2015-08-20
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 |
|---|---|---|---|---|
| I20150820011743 | I | Physician Assistant | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 13501)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Marriage And Family Therapist | CA | |
| Family Practice | CA | |
| Physical Medicine And Rehabilitation | CO | |
| Marriage And Family Therapist | CA | |
| Family Practice | CA | |
| Anesthesiology, Pain Management | CA | |
| O P H T H A L M O L O G Y | IA | |
| Clinical Social Worker | MD | |
| - | CA | |
| Clinical Social Worker | CA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.