LIA BACK (PA) – Physician Assistant, NPI 1669486197
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LIA BACK (PA)
145 Citizens Ln
Hazard, KY 417011320
Phone: (606) 439-1300
Fax: (606) 436-5282
Type: Location
1221 S BROADWAY
LEXINGTON, KY 405042701
Phone: (859) 258-6200
Fax: (859) 258-6203
Type: Mailing
Hazard Post Office, Main Street, Hazard, Perry County, Kentucky, 41729, United States
HAZARD, KY 417021988
Phone: (606) 439-1300
Fax: (606) 436-5282
Type: Mailing
Citizens Lane, Hazard, Perry County, Kentucky, 41729, United States
HAZARD, KY 417011320
Phone: (606) 439-1300
Fax: (606) 436-5282
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: 2014-10-29
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 |
|---|---|---|---|---|
| I20041012000265 | I | Physician Assistant | KY | TBD |
| I20141029001379 | I | Physician Assistant | IN | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 58 | 57 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 55 | 54 | $0 |
Insurance plans in this area (ZIP 41701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | KY | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 27 | 27 |
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