GREGORY JAMES STATEN (PA) – Physician Assistant, NPI 1194703660
Physician Assistant
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for GREGORY JAMES STATEN (PA)
3533 SOUTHERN BLVD STE 2100
KETTERING, OH 454291267
Phone: (937) 395-8556
Fax: (937) 522-7873
Type: Mailing
Kettering Medical Center, 3535, Southern Boulevard, Kettering, Montgomery County, Ohio, 45429, United States
KETTERING, OH 454291221
Phone: (937) 395-6010
Type: Location
2110, Leiter Road, Miamisburg, Montgomery County, Ohio, 45342, United States
MIAMISBURG, OH 453423660
Phone: (937) 914-7054
Fax: (937) 522-7685
Type: Mailing
4600 MONTGOMERY RD STE 400
CINCINNATI, OH 452122600
Phone:
Type: Mailing
4421 ROOSEVELT BLVD
MIDDLETOWN, OH 450449023
Phone: (833) 510-4357
Type: Location
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 $28.
Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.
Last reported payment date: 2024-02-15 • Largest payer in this snapshot: Braeburn Inc. ($28).
Total Amount
$28
General + Research + Ownership
Payments
1
Total payment records
General Amount
$28
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Braeburn Inc. | $28 |
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: 2005-06-13
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 |
|---|---|---|---|---|
| I20050613000647 | I | Physician Assistant | OH | 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 45429)
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