KENT B WHITAKER (PA) – Physician Assistant, NPI 1487635579
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KENT B WHITAKER (PA)
550, East 1400 North, Logan, Cache County, Utah, 84341, United States
STE R
LOGAN, UT 843412406
Phone: (435) 755-9484
Fax: (435) 755-2832
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)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2008-08-11
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 |
|---|---|---|---|---|
| I20080811000147 | I | Physician Assistant | UT | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 167 | 40 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 59 | 54 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 53 | 49 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 22 | 21 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 22 | 21 | $0 |
Insurance plans in this area (ZIP 84341)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CO | |
| Physician Assistant | UT | |
| D E R M A T O L O G Y | UT | |
| Nurse Practitioner | UT | |
| D E R M A T O L O G Y | MN |
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