KELLEY L. PASTOR (PA-C) – Physician Assistant, NPI 1245411495
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for KELLEY L. PASTOR (PA-C)
9485 Mentor Avenue
Suite 210
Mentor, OH 44060
Phone: (440) 205-5848
Fax: (440) 255-5548
Type: Location
1940 SANDGATE RD
MADISON, OH 440571849
Phone: (440) 428-0540
Type: Location
Mentor Avenue, Mentor, Lake County, Ohio, 44060, United States
SUITE 100
MENTOR, OH 440608713
Phone: (440) 352-4880
Type: Mailing
9220 MENTOR AVE
MENTOR, OH 440606412
Phone: (440) 354-9924
Fax: (877) 242-9583
Type: Location
9485 MENTOR AVENUE
SUITE 210
MENTOR, OH 440608713
Phone: (440) 205-5848
Fax: (440) 255-5548
Type: Mailing
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 $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2024-07-16 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $20 |
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: 2008-01-09
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 |
|---|---|---|---|---|
| I20080109000607 | I | Physician Assistant | 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.
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 | 30 | 19 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 44060)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | OH | 85610 | Blood test, clotting time | 112 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | AZ | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Family Practice | OH | |
| Nurse Practitioner | OH |
Reviews
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