KELLY PETERS (PA-C) – Physician Assistant, NPI 1144666793
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KELLY PETERS (PA-C)
4031 W PLANO PKWY
SUITE 100
PLANO, TX 750935619
Phone: (972) 985-1072
Fax: (972) 596-9382
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $587.
Total Amount is formed as General ($587) + Research ($0) + Ownership ($0) = $587.
Last reported payment date: 2024-05-01 • Largest payer in this snapshot: Medtronic, Inc. ($264).
Total Amount
$587
General + Research + Ownership
Payments
14
Total payment records
General Amount
$587
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-01
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2015-02-18
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 |
|---|---|---|---|---|
| I20150218001551 | 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 |
|---|---|---|---|---|
| 80307 | Testing for presence of drug, by chemistry analyzers | 12 | 12 | $0 |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 12 | 12 | $0 |
Insurance plans in this area (ZIP 75093)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Physician Assistant | TX | |
| - | TX | |
| Physician Assistant | TX | |
| Occupational Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | TX | |
| Occupational Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | TX |
Reviews
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