NICOLE L DUSENBURY (PA-C) – Physician Assistant, NPI 1982925301
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for NICOLE L DUSENBURY (PA-C)
5050 SKYLINE VILLAGE LOOP S
SALEM, OR 973069490
Phone: (035) 391-1110
Fax: (503) 370-4237
Type: Location
89 HOOKELE ST
#103
KAHULUI, HI 967323532
Phone: (808) 871-8878
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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: 2024-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20110509000111 | I | Physician Assistant | NY | TBD |
| I20160202000368 | I | Physician Assistant | HI | TBD |
| I20220429001287 | I | Physician Assistant | OR | TBD |
| I20240604004529 | I | Physician Assistant | WA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 197 | 112 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 74 | 74 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 74 | 66 | $0 |
| G0008 | Administration of influenza virus vaccine | 38 | 37 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 32 | 31 | $0 |
Insurance plans in this area (ZIP 97306)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NY | |
| Nurse Practitioner | NY | |
| Emergency Medicine | NY | |
| - | NY | |
| Family Practice | NY | |
| - | VA | |
| Emergency Medicine | NY | |
| Emergency Medicine | NY | |
| Emergency Medicine | NY | |
| - | NY |
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