KRISTINE R NILES – Physician Assistant, NPI 1184366551
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,972 PHYSICIAN ASSISTANT in UT
Provider Addresses for KRISTINE R NILES
1697 Stucki Dr
Santa Clara, UT 847655142
Phone: (509) 405-3100
Type: Location
1697 STUCKI DR
SANTA CLARA, UT 847655142
Phone: (509) 405-3100
Type: Mailing
PO BOX 1189
CORVALLIS, OR 973391189
Phone:
Type: Mailing
1086 7TH AVE SW STE 101
ALBANY, OR 973211954
Phone: (541) 812-5530
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 $94.
Total Amount is formed as General ($94) + Research ($0) + Ownership ($0) = $94.
Last reported payment date: 2024-04-10 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($94).
Total Amount
$94
General + Research + Ownership
Payments
1
Total payment records
General Amount
$94
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $94 |
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: 2024-09-19
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 |
|---|---|---|---|---|
| I20240919001113 | I | Physician Assistant | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84765)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | OR | |
| - | OR | |
| - | OR | |
| - | OR | |
| Clinical Psychologist | OR | |
| Internal Medicine, Pediatric Medicine | OR | |
| Family Practice | OR | |
| - | OR | |
| Hospitalist, Family Practice | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OR |
Reviews
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