KIMBERLY C SUPPES (M.D.) – Surgery Physician, NPI 1821042060
Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
55 SURGICAL ONCOLOGY in VA
Provider Addresses for KIMBERLY C SUPPES (M.D.)
595 MARTHA JEFFERSON DR STE 320
CHARLOTTESVILLE, VA 229114669
Phone: (434) 654-8715
Type: Location
3220 Bluff Creek Dr
Suite 100
Columbia, MO 652013663
Phone: (573) 443-8773
Fax: (573) 443-6843
Type: Location
3220, Bluff Creek Drive, Columbia, Boone County, Missouri, 65201, United States
SUITE 100
COLUMBIA, MO 652013663
Phone: (573) 443-8773
Fax: (573) 443-6843
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $239.
Total Amount is formed as General ($239) + Research ($0) + Ownership ($0) = $239.
Last reported payment date: 2024-03-13 • Largest payer in this snapshot: Elucent Medical ($192).
Total Amount
$239
General + Research + Ownership
Payments
3
Total payment records
General Amount
$239
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Elucent Medical | $192 |
| Molli Surgical (us) Inc | $47 |
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: 2023-01-12
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 |
|---|---|---|---|---|
| I20230112000267 | I | Surgical Oncology | 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 |
|---|---|---|---|---|
| 76642 | Limited ultrasound scan of 1 breast | 75 | 60 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 31 | 31 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 28 | 28 | $0 |
| 19301 | Partial removal of breast | 27 | 24 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 26 | 21 | $0 |
Insurance plans in this area (ZIP 22911)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | MO | 38900 | Lymph node imaging during surgery | 40 | 40 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | MD | |
| Nurse Practitioner | VA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | VA | |
| Vascular Surgery, General Surgery | VA | |
| - | MD | |
| - | VA | |
| N E U R O S U R G E R Y | MD | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | MD | |
| - | MD |
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