KATHLEEN KETELSON (FNP) – Nurse Practitioner, NPI 1033428198
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for KATHLEEN KETELSON (FNP)
560 WALLACE RD NW STE 140
SALEM, OR 973043858
Phone: (888) 524-8219
Type: Mailing
PO BOX 1200
PLEASANT GROVE, UT 840621200
Phone: (800) 640-3451
Type: Mailing
4921 E BELL RD STE 205
SCOTTSDALE, AZ 852546002
Phone: (800) 640-3451
Type: Location
560 Wallace Rd NW Ste 140
Salem, OR 97304
Phone: (888) 524-8219
Type: Location
2001 NW Monroe Ave
Suite 104
Corvallis, OR 973305508
Phone: (541) 754-1369
Type: Location
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: 2024-02-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20101230000399 | I | Nurse Practitioner | OR | TBD |
| I20240212000940 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 66 | 66 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 48 | 41 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 32 | 29 | $0 |
| 81007 | Urinalysis for bacteria | 29 | 23 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 26 | 13 | $0 |
Insurance plans in this area (ZIP 97304)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX |
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.