JACK ALAN KAMENSKE (MSN, RN, FNP-BC) – Pediatric Nurse Practitioner, NPI 1669012837
Pediatric Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JACK ALAN KAMENSKE (MSN, RN, FNP-BC)
16452 BOARDWALK TER
ORLAND HILLS, IL 604875617
Phone:
Type: Mailing
12251 S 80TH AVE STE 204
PALOS HEIGHTS, IL 604631256
Phone: (773) 432-4800
Fax: (844) 805-4742
Type: Location
29373 NETWORK PL
CHICAGO, IL 606731293
Phone: (847) 390-5900
Type: Mailing
12251 S 80th Ave Ste 204
Palos Heights, IL 604631256
Phone: (773) 432-4800
Fax: (844) 805-4742
Type: Location
4950 W 95th St
Oak Lawn, IL 604532504
Phone: (773) 432-4800
Type: Location
1006 S Michigan Ave Ste 500
Chicago, IL 606052216
Phone: (773) 432-4888
Type: Location
16515 106th Ct
Orland Park, IL 604674545
Phone: (773) 726-0853
Fax: (773) 702-4666
Type: Location
4440 W 95TH ST
OAK LAWN, IL 604532600
Phone: (708) 684-5580
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $184.
Total Amount is formed as General ($184) + Research ($0) + Ownership ($0) = $184.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Boston Scientific Corporation ($167).
Total Amount
$184
General + Research + Ownership
Payments
4
Total payment records
General Amount
$184
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $167 |
| PFIZER INC. | $17 |
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: 2020-04-01
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 |
|---|---|---|---|---|
| I20200401001250 | I | Nurse Practitioner | IL | 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 60487)
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