MR. KENNETH JOHN BANNON (BSPA-C) – Physician Assistant, NPI 1821055047
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,691 PHYSICIAN ASSISTANT in PA
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Provider Addresses for MR. KENNETH JOHN BANNON (BSPA-C)
Wayne Memorial Hospital, 601, Park Street, Honesdale, Wayne County, Pennsylvania, 18431, United States
HONESDALE, PA 184311445
Phone:
Type: Mailing
111, Salem Avenue, Carbondale, Lackawanna County, Pennsylvania, 18407, United States
SUITE 302
CARBONDALE, PA 184072574
Phone: (570) 282-2031
Fax: (570) 282-2534
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 134 Open Payments records for all available years, with a total value of $3,675.
Total Amount is formed as General ($3,675) + Research ($0) + Ownership ($0) = $3,675.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($1,133).
Total Amount
$3,675
General + Research + Ownership
Payments
134
Total payment records
General Amount
$3,675
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,133 |
| Janssen Biotech, Inc. | $500 |
| QOL Medical, LLC | $275 |
| Salix Pharmaceuticals, a division of Bausch Health US, LLC | $267 |
| Phathom Pharmaceuticals, Inc. | $210 |
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: 2023-01-12
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 |
|---|---|---|---|---|
| I20230112001334 | I | Physician Assistant | DE | 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 | 369 | 312 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 226 | 226 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 204 | 182 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 165 | 165 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 18431)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | PA | |
| Certified Registered Nurse Anesthetist (Crna) | DE | |
| Physician Assistant | PA | |
| Nurse Practitioner | DE | |
| Certified Registered Nurse Anesthetist (Crna) | PA | |
| - | DE | |
| Gastroenterology, Internal Medicine | DE | |
| A N E S T H E S I O L O G Y | NY | |
| Physician Assistant | DE | |
| Certified Registered Nurse Anesthetist (Crna) | PA |
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