MS. KONNEEN WILLIS (PA) – Medical Physician Assistant, NPI 1861510240
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for MS. KONNEEN WILLIS (PA)
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone: (801) 408-7660
Fax: (801) 408-7650
Type: Mailing
1551 RENAISSANCE TOWNE DR
STE 460
BOUNTIFUL, UT 840107667
Phone: (801) 294-7246
Fax: (801) 294-2560
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $859.
Total Amount is formed as General ($859) + Research ($0) + Ownership ($0) = $859.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Relievant Medsystems, Inc. ($495).
Total Amount
$859
General + Research + Ownership
Payments
25
Total payment records
General Amount
$859
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
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: 2007-07-31
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 |
|---|---|---|---|---|
| I20070731000062 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 977 | 344 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 39 | 28 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 31 | 19 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 22 | 22 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 84127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Interventional Pain Management | UT |
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