KRISTEN ANNE THEOBALD-HAZEL (DO) – Pediatrics Physician, NPI 1932201837
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KRISTEN ANNE THEOBALD-HAZEL (DO)
1501, Union Avenue, Moberly, Randolph County, Missouri, 65270, United States
SUITE A
MOBERLY, MO 652709469
Phone: (660) 263-9095
Fax: (660) 263-0054
Type: Location
54 HOSPITAL DR
OSAGE BEACH, MO 650653050
Phone: (573) 302-3100
Fax: (573) 348-8279
Type: Mailing
1057 MEDICAL PARK DR
OSAGE BEACH, MO 650653000
Phone: (573) 302-3100
Fax: (573) 348-8279
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 58 Open Payments records for all available years, with a total value of $1,039.
Total Amount is formed as General ($1,039) + Research ($0) + Ownership ($0) = $1,039.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Novo Nordisk Inc ($189).
Total Amount
$1,039
General + Research + Ownership
Payments
58
Total payment records
General Amount
$1,039
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $189 |
| Amgen Inc. | $171 |
| GlaxoSmithKline, LLC. | $98 |
| IRONWOOD PHARMACEUTICALS, INC | $45 |
| Neurocrine BioSciences, Inc. | $45 |
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: 2009-07-21
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 |
|---|---|---|---|---|
| I20090721000539 | I | Pediatric Medicine | MO | 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 65270)
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