LAURA KITZMILLER (M.D.) – Pediatrics Physician, NPI 1962728113
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LAURA KITZMILLER (M.D.)
14719 W UPRIGHT ST
CHARLEVOIX, MI 497201949
Phone: (231) 547-3840
Fax: (231) 392-7730
Type: Mailing
14700 Lake Shore Dr
Charlevoix, MI 497201999
Phone: (231) 547-3840
Type: Location
Essentia South University Clinic, 1702, South University Drive, Clara Barton, Fargo, Cass County, North Dakota, 58103, United States
FARGO, ND 581034940
Phone:
Type: Mailing
400, East 3rd Street, Duluth, Saint Louis County, Minnesota, 55805, United States
DULUTH, MN 558051951
Phone: (218) 786-8364
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: 2019-10-17
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 |
|---|---|---|---|---|
| I20160916001658 | I | Pediatric Medicine | MI | TBD |
| I20191017002365 | I | Critical Care (Intensivists) | MN | 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 49720)
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