KENNETH CUSHING BOTELHO (PA-C) – Physician Assistant, NPI 1184977514
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
774 PHYSICIAN ASSISTANT in RI
Provider Addresses for KENNETH CUSHING BOTELHO (PA-C)
450 VETERANS MEMORIAL PKWY BLDG 9
EAST PROVIDENCE, RI 029145300
Phone: (401) 435-5533
Fax: (401) 435-3586
Type: Location
440 1/2 MAIN ST
ONEONTA, NY 138202027
Phone: (607) 431-5619
Type: Mailing
1 NORTON AVE
ONEONTA, NY 138202629
Phone: (607) 431-5619
Type: Location
4855 W Arrowhead Rd
Hermantown, MN 558113936
Phone: (218) 786-3540
Type: Location
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 $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2023-06-28 • Largest payer in this snapshot: Mylan Specialty L.P. ($124).
Total Amount
$124
General + Research + Ownership
Payments
1
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mylan Specialty L.P. | $124 |
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: 2025-05-23
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 |
|---|---|---|---|---|
| I20131009001819 | I | Physician Assistant | RI | TBD |
| I20250523000221 | I | Physician Assistant | MN | 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 | 323 | 156 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 151 | 106 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 52 | 46 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 38 | 31 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 28 | 24 | $0 |
Insurance plans in this area (ZIP 02914)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MT | |
| - | ND | |
| Physician Assistant | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Qualified Audiologist | MN | |
| - | MN | |
| - | MN | |
| P A T H O L O G Y | WV | |
| Family Practice | MN |
Reviews
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