CARISSA LYNN PARDEKOOPER (PA-C) – Physician Assistant, NPI 1063815017
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,429 PHYSICIAN ASSISTANT in VA
Provider Addresses for CARISSA LYNN PARDEKOOPER (PA-C)
2117 GENERAL BOOTH BLVD
VIRGINIA BEACH, VA 234545803
Phone: (757) 689-8183
Type: Mailing
4909 N GLEN PARK PLACE RD
PEORIA, IL 616144676
Phone: (309) 674-7546
Fax: (309) 691-9286
Type: Mailing
1800 E. 54TH STREET
STE B
DAVENPORT, IA 528072763
Phone: (563) 344-7546
Fax: (563) 344-1373
Type: Location
850 KEMPSVILLE RD STE 100D
NORFOLK, VA 235023920
Phone: (757) 261-5944
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $168.
Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.
Last reported payment date: 2023-09-13 • Largest payer in this snapshot: ABBVIE INC. ($103).
Total Amount
$168
General + Research + Ownership
Payments
2
Total payment records
General Amount
$168
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $103 |
| Janssen Biotech, Inc. | $65 |
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: 2021-10-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20150105001247 | I | Physician Assistant | IL | TBD |
| I20211019002635 | I | Physician Assistant | VA | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 1,157 | 788 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,132 | 317 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 651 | 465 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 296 | 261 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 177 | 152 | $0 |
Insurance plans in this area (ZIP 23454)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 17003 | Destruction of 2-14 skin growths | 84 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | VA | |
| Physician Assistant | VA |
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