DR. KEVIN ALLEN KASYCH (M.D.) – Pediatrics Physician, NPI 1629079405
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. KEVIN ALLEN KASYCH (M.D.)
PO BOX 45443
SALT LAKE CITY, UT 841450443
Phone: (904) 202-1032
Fax: (904) 376-4107
Type: Mailing
Old Saint Augustine Road, Bayard, Jacksonville, Duval County, Florida, 32258, United States
CREDENTIALING DEPARTMENT
JACKSONVILLE, FL 322582558
Phone: (904) 268-7701
Fax: (904) 268-9708
Type: Location
4215 PLANTATION OAKS BLVD
ORANGE PARK, FL 320653641
Phone: (904) 633-0820
Fax: (904) 633-8021
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 33 Open Payments records for all available years, with a total value of $645.
Total Amount is formed as General ($645) + Research ($0) + Ownership ($0) = $645.
Last reported payment date: 2024-07-04 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($178).
Total Amount
$645
General + Research + Ownership
Payments
33
Total payment records
General Amount
$645
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $178 |
| PFIZER INC. | $79 |
| GlaxoSmithKline, LLC. | $73 |
| Ironshore Pharmaceuticals Inc. | $70 |
| SANOFI PASTEUR INC. | $58 |
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: 2024-05-14
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 |
|---|---|---|---|---|
| I20240514003413 | I | Pediatric Medicine | FL | 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 84145)
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