KENNETH PELLETIER PA-C
NPI 1265488662
Physician Assistant - Surgical in Raleigh, NC
NPI Status: Active since May 26, 2006
Contact Information
3404 WAKE FOREST RD
STE 201
RALEIGH, NC
ZIP 27609
Phone: (919) 256-1511
Fax: (919) 256-1530
- Individual
- Male
- Years of Experience 28
- Physician Assistant
- Surgical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KENNETH PELLETIER
This page provides the complete NPI Profile along with additional information for Kenneth Pelletier, a provider established in Raleigh, North Carolina with a medical specialization in Physician Assistant, focusing in surgical and more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1265488662 assigned on May 2006. The practitioner's primary taxonomy code is 363AS0400X with license number 102579 (NC). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1265488662
- Provider Name
- KENNETH PELLETIER PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3404 WAKE FOREST RD STE 201 RALEIGH, NC 27609
- Location Phone
- (919) 256-1511
- Location Fax
- (919) 256-1530
- Mailing Address
- 3404 WAKE FOREST RD STE 201 RALEIGH, NC 27609
- Mailing Phone
- (919) 256-1511
- Mailing Fax
- (919) 256-1530
- Medical School Name
- OTHER
- Graduation Year
- 1998
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-26-2006
- Last Update Date
- 08-12-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 102579
- License State
- NC
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2749174B | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 568046 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Kenneth Pelletier is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kenneth Pelletier is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3476678772
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20100909001023
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Anchoring of biceps tendon
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Partial removal of collar bone at shoulder using an endoscope
Prosthetic repair of shoulder joint, total shoulder
Release of tendon connecting biceps muscle and shoulder using an endoscope
Removal of extensive shoulder joint tissue using an endoscope
Repair of acute torn shoulder rotator cuff
Repair of chronic torn shoulder rotator cuff
Shaving of part of shoulder bone and repair of ligament using an endoscope
Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.
This service was performed 39 times for 39 patientsThis procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 145 times for 65 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 126 times for 56 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 572 times for 65 patientsThis procedure involves the partial removal of the collar bone at the shoulder using an endoscope, a tool with a light and camera. It's done to relieve pain or improve shoulder movement. The surgeon makes small incisions, then uses the endoscope to guide their work.
This service was performed 77 times for 76 patientsTotal shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.
This service was performed 22 times for 21 patientsThis procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.
This service was performed 37 times for 36 patientsThis procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.
This service was performed 37 times for 37 patientsRepair of an acute torn shoulder rotator cuff is a surgical procedure aimed at mending a tear in the shoulder's rotator cuff. It involves reattaching the torn tendon to the head of the upper arm bone. This helps restore shoulder strength and function, alleviating pain and discomfort.
This service was performed 18 times for 17 patientsRepair of a chronic torn shoulder rotator cuff is a surgical procedure aimed at mending the damaged tendon in your shoulder. This helps restore shoulder strength and functionality, alleviating pain and discomfort caused by the tear.
This service was performed 34 times for 34 patientsThis procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.
This service was performed 83 times for 82 patientsFind Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kenneth Pelletier is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| DUKE UNIVERSITY HOSPITAL | 2100 ERWIN RD DURHAM, NC 27705 | (919) 684-8111 | Acute Care Hospitals | |
| FIRSTHEALTH MOORE REGIONAL HOSPITAL | 155 MEMORIAL DRIVE PINEHURST, NC 28374 | (910) 715-1000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1265488662, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
RALEIGH, NC 27609
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265488662, enumerated as an "individual" on May 26, 2006.
The provider is located at 3404 WAKE FOREST RD STE 201 RALEIGH, NC 27609 and the phone number is (919) 256-1511.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
Kenneth Pelletier is affiliated with: DUKE UNIVERSITY HOSPITAL and FIRSTHEALTH MOORE REGIONAL HOSPITAL.