MR. KACEY L ANDREASEN (PA-C) – Medical Physician Assistant, NPI 1215160510
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for MR. KACEY L ANDREASEN (PA-C)
1050 SW 3RD AVE STE 1200
ONTARIO, OR 979144550
Phone: (541) 889-3111
Fax: (541) 889-3999
Type: Location
South 10th Avenue, Caldwell, Canyon County, Idaho, 83605, United States
CALDWELL, ID 83605
Phone: (208) 459-7788
Fax: (208) 455-3277
Type: Mailing
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 $107.
Total Amount is formed as General ($107) + Research ($0) + Ownership ($0) = $107.
Last reported payment date: 2024-08-26 • Largest payer in this snapshot: Heron Therapeutics, Inc. ($89).
Total Amount
$107
General + Research + Ownership
Payments
2
Total payment records
General Amount
$107
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Heron Therapeutics, Inc. | $89 |
| Bioventus LLC | $18 |
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: 2014-07-09
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 |
|---|---|---|---|---|
| I20140709002021 | I | Physician Assistant | ID | 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 |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 22 | 22 | $0 |
Insurance plans in this area (ZIP 97914)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | ME | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | TX | |
| - | OR | |
| Hand Surgery | ID | |
| - | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| General Surgery | ID |
Reviews
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