KENNETH ALLEN MITCHELL (PA-C) – Physician Assistant, NPI 1922096379
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KENNETH ALLEN MITCHELL (PA-C)
6025, Lake Road, Woodbury, Washington County, Minnesota, 55125, United States
SUITE 200
WOODBURY, MN 551251712
Phone: (651) 999-6800
Fax: (651) 999-6830
Type: Mailing
1300 CENTERVIEW DR
LITTLE ROCK, AR 722114349
Phone: (501) 219-8900
Fax: (501) 410-1148
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 92 Open Payments records for all available years, with a total value of $28,355.
Total Amount is formed as General ($28,355) + Research ($0) + Ownership ($0) = $28,355.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Antares Pharma, Inc. ($14,097).
Total Amount
$28,355
General + Research + Ownership
Payments
92
Total payment records
General Amount
$28,355
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Antares Pharma, Inc. | $14,097 |
| Endo Pharmaceuticals Inc. | $10,256 |
| Endo USA, Inc. | $2,700 |
| COLOPLAST CORP | $421 |
| Boston Scientific Corporation | $370 |
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: 2023-02-02
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 |
|---|---|---|---|---|
| I20230202002124 | I | Physician Assistant | TN | 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 |
|---|---|---|---|---|
| J1071 | Injection, testosterone cypionate, 1 mg | 9,500 | 52 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 93 | 53 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 62 | 59 | $0 |
| 11980 | Placement of hormone pellet under skin | 55 | 50 | $0 |
| J3490 | Unclassified drugs | 50 | 47 | $0 |
Insurance plans in this area (ZIP 55125)
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