KELLY PHAN VAN (DO) – Obstetrics & Gynecology Physician, NPI 1093344889
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,818 OBSTETRICS/GYNECOLOGY in OH
Provider Addresses for KELLY PHAN VAN (DO)
7488 State Route 241
Millersburg, OH 446548383
Phone: (330) 202-5662
Fax: (330) 202-5663
Type: Location
1 AKRON GENERAL AVE
AKRON, OH 443072432
Phone:
Type: Mailing
546 WINTER ST STE 100
WOOSTER, OH 446912339
Phone: (330) 202-5662
Fax: (330) 202-5663
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $61.
Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.
Last reported payment date: 2024-08-08 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($32).
Total Amount
$61
General + Research + Ownership
Payments
2
Total payment records
General Amount
$61
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $32 |
| ABBVIE INC. | $29 |
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: 2025-11-13
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 |
|---|---|---|---|---|
| I20251113000237 | I | Obstetrics/Gynecology | OH | 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 44654)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | OH | |
| Internal Medicine | OH | |
| Orthopedic Surgery | OH | |
| Cardiovascular Disease (Cardiology) | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Pulmonary Disease, Critical Care (Intensivists) | OH | |
| Physician Assistant | OH | |
| Nurse Practitioner | OH | |
| General Surgery | OH |
Reviews
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