MS. KASEY JO ZAWODNIAK (RN, CPNP-AC) – Nurse Practitioner, NPI 1194775544
Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. KASEY JO ZAWODNIAK (RN, CPNP-AC)
1465 S Grand Blvd
Saint Louis, MO 631041003
Phone: (314) 577-5395
Fax: (314) 268-6459
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN 462025109
Phone: (317) 948-0944
Fax: (317) 274-2940
Type: Location
SSM Health Cardinal Glennon Children’s Hospital, 1465, South Grand Boulevard, Tiffany, City of Saint Louis, Missouri, 63104, United States
SAINT LOUIS, MO 631041003
Phone: (314) 577-5395
Fax: (314) 268-6459
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 $52.
Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.
Last reported payment date: 2024-11-04 • Largest payer in this snapshot: Medtronic, Inc. ($52).
Total Amount
$52
General + Research + Ownership
Payments
1
Total payment records
General Amount
$52
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $52 |
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: 2023-09-06
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 |
|---|---|---|---|---|
| I20230906001384 | I | Nurse Practitioner | NC | 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 63104)
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