CANDICE KETELSEN (PA-C) – Physician Assistant, NPI 1073040515
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,534 PHYSICIAN ASSISTANT in ID
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Provider Addresses for CANDICE KETELSEN (PA-C)
Iron Bridge Way, East Central, Spokane, Spokane County, Washington, 99202, United States
SPOKANE, WA 992024932
Phone: (509) 444-8888
Type: Mailing
1203, Idaho Street, Lewiston, Nez Perce County, Idaho, 83501, United States
LEWISTON, ID 835011940
Phone: (208) 848-8300
Type: Location
2500 W A ST STE 101
MOSCOW, ID 838436000
Phone: (208) 882-0540
Fax: (208) 883-1853
Type: Location
1000 SE TECH CENTER DR
VANCOUVER, WA 986835547
Phone: (360) 487-4660
Type: Mailing
1000 SE TECH CENTER DR STE 120
VANCOUVER, WA 986835548
Phone: (360) 487-4660
Type: Location
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: 2017-08-16
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 |
|---|---|---|---|---|
| I20170816003731 | I | Physician Assistant | WA | TBD |
| I20170816003937 | I | Physician Assistant | ID | 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 |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 20 | 17 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 15 | $0 |
| 81003 | Automated urinalysis test | 12 | 12 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 99202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| - | ID | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID | |
| Family Practice | ID | |
| Family Practice | ID | |
| Family Practice | WA | |
| Physician Assistant | ID | |
| Physician Assistant | WA |
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