KELLY N O'CONNOR – Dermatology Physician, NPI 1841849312
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
324 PHYSICIAN ASSISTANT in WY
Provider Addresses for KELLY N O'CONNOR
PO BOX 14510
JACKSON, WY 830024510
Phone: (307) 734-1800
Fax: (307) 734-5012
Type: Mailing
984 W BROADWAY
STE 4
JACKSON, WY 83001
Phone: (307) 734-1800
Type: Location
11th Avenue Northeast, University District, Seattle, King County, Washington, 98105-6286, United States
SEATTLE, WA 981056367
Phone: (206) 616-4001
Fax: (206) 616-3889
Type: Mailing
4311 11th Ave NE Ste 200
Seattle, WA 981056367
Phone: (206) 616-4001
Fax: (206) 616-3889
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $254.
Total Amount is formed as General ($254) + Research ($0) + Ownership ($0) = $254.
Last reported payment date: 2024-08-14 • Largest payer in this snapshot: GENZYME CORPORATION ($74).
Total Amount
$254
General + Research + Ownership
Payments
11
Total payment records
General Amount
$254
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-14
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: 2021-11-15
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 |
|---|---|---|---|---|
| I20211115002339 | I | Physician Assistant | WY | 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 |
|---|---|---|---|---|
| J7345 | Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg | 8,400 | 34 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 865 | 138 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 212 | 172 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 206 | 173 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 104 | 97 | $0 |
Insurance plans in this area (ZIP 83002)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | WY | |
| D E R M A T O L O G Y | WY | |
| Physician Assistant | WY | |
| D E R M A T O L O G Y | CA |
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