Mary Alice Disselkamp, PA-C
NPI 1043876170ActiveIndividual· Physician Assistant· Elizabethtown, KY
Physician Assistant (PA-C) with Radiology Associates Inc, practicing in Elizabethtown, Kentucky. Medicare paid $25,420 for services to 1,281 patients in 2024. Eisai Inc. reported $23.30 in payments in 2024, mostly food and beverage. Lists Baptist Health Hardin as a hospital affiliation.
Overview
| NPI | 1043876170 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | May 14, 2019 |
| Last updated in NPPES | Nov 8, 2023 |
| Certified by provider | Nov 8, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (KY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 1,281 |
|---|---|
| Services billed | 1,522 across 31 procedure codes |
| Paid by Medicare | $25,420 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Radiology Associates IncElizabethtown, KY · 61 clinicians
Hospital affiliation
- Baptist Health HardinElizabethtown, KY
Industry payments (Open Payments)
- 2024$23.30 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Eisai Inc. | $23.30 | 1 |
What the 2024 payments were for
- Food and Beverage$23.30 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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