DR. ETHAN B COLLIVER (D.O.) – Physical Medicine & Rehabilitation Physician, NPI 1184803330
Physical Medicine & Rehabilitation Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
346 PHYSICAL MEDICINE AND REHABILITATION in VA
Provider Addresses for DR. ETHAN B COLLIVER (D.O.)
120 PROFESSIONAL PARK DR SE STE 7
BLACKSBURG, VA 240606739
Phone: (540) 443-3832
Fax: (540) 443-9362
Type: Mailing
122 12TH ST
PRINCETON, WV 247402312
Phone: (304) 425-7127
Fax: (304) 487-7235
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 $1,429.
Total Amount is formed as General ($0) + Research ($1,429) + Ownership ($0) = $1,429.
Last reported payment date: 2023-01-26 • Largest payer in this snapshot: Bioventus LLC ($1,429).
Total Amount
$1,429
General + Research + Ownership
Payments
1
Total payment records
General Amount
$0
General payments
Research Amount
$1,429
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bioventus LLC | $1,429 |
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: 2025-11-18
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 |
|---|---|---|---|---|
| I20091006000220 | I | Physical Medicine And Rehabilitation | VA | TBD |
| I20251118002922 | I | Physical Medicine And Rehabilitation | WV | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 289 | 125 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 207 | 100 | $0 |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | 101 | 81 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 89 | 52 | $0 |
| 96132 | Evaluation of neuropsychological test, first hour | 73 | 61 | $0 |
Insurance plans in this area (ZIP 24060)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| Family Practice | VA | |
| Physician Assistant | WV | |
| - | TX | |
| Physician Assistant | WV | |
| Physician Assistant | WV | |
| Physician Assistant | WV | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | WV | |
| O T O L A R Y N G O L O G Y | WV | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | WV |
Reviews
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