DR. KRISTINE JANE THAYER (M.D.) – Pediatric Surgery Physician, NPI 1366464950
Pediatric Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. KRISTINE JANE THAYER (M.D.)
2350, North Rockton Avenue, Rockford, Winnebago County, Illinois, 61103, United States
PEDIATRIC SURGERY
ROCKFORD, IL 611033600
Phone: (815) 971-7255
Fax: (815) 971-9955
Type: Location
400 N 9th Street Suite 2400
Springfield, IL 627693600
Phone: (217) 757-6535
Type: Location
2350 N Rockton Ave
Pediatric Surgery
Rockford, IL 611033600
Phone: (815) 971-7255
Fax: (815) 971-9955
Type: Location
1600 MEDICAL CENTER DR STE 2500
HUNTINGTON, WV 257013657
Phone: (304) 691-1200
Type: Location
12232, North Ledges Drive, Roscoe Township, Winnebago County, Illinois, 61073, United States
ROSCOE, IL 610739612
Phone: (815) 262-7241
Type: Mailing
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 $110.
Total Amount is formed as General ($110) + Research ($0) + Ownership ($0) = $110.
Last reported payment date: 2023-03-20 • Largest payer in this snapshot: Davol Inc. ($110).
Total Amount
$110
General + Research + Ownership
Payments
1
Total payment records
General Amount
$110
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Davol Inc. | $110 |
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: 2022-03-21
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 |
|---|---|---|---|---|
| I20120925000307 | I | General Surgery | IL | TBD |
| I20220321001122 | I | Pediatric Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61103)
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