SUSAN KELLER – Physician Assistant, NPI 1104201813
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for SUSAN KELLER
4819 River Oaks Blvd
Fort Worth, TX 76114
Phone: (817) 626-9744
Type: Location
6551 HARRIS PKWY STE 250
FORT WORTH, TX 761326115
Phone: (713) 824-1883
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $486.
Total Amount is formed as General ($486) + Research ($0) + Ownership ($0) = $486.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Novo Nordisk Inc ($136).
Total Amount
$486
General + Research + Ownership
Payments
26
Total payment records
General Amount
$486
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $136 |
| IDORSIA PHARMACEUTICALS US INC | $65 |
| Eisai Inc. | $44 |
| Inspire Medical Systems, Inc. | $38 |
| Teva Pharmaceuticals USA, Inc. | $34 |
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: 2016-08-01
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 |
|---|---|---|---|---|
| I20160801001010 | I | Physician Assistant | TX | 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 |
|---|---|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 274 | 274 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 263 | 172 | $0 |
| 64450 | Injection of anesthetic agent and/or steroid into other nerve or branch | 46 | 35 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 46 | 39 | $0 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 26 | 21 | $0 |
Insurance plans in this area (ZIP 76114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| Qualified Audiologist | TX | |
| Internal Medicine | TX | |
| - | TX | |
| General Surgery, Colorectal Surgery (Proctology) | TX | |
| O P H T H A L M O L O G Y | TX | |
| - | TX | |
| - | TX | |
| Orthopedic Surgery | TX | |
| - | TX |
Reviews
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