DR. KENNETH DAVID TERRY (DO) – Family Medicine Physician, NPI 1144712902
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
Provider Addresses for DR. KENNETH DAVID TERRY (DO)
801 E MOUNTAIN VIEW ST STE F
BARSTOW, CA 923113052
Phone: (760) 256-1777
Type: Mailing
500 S 7TH AVE STE B&C
BARSTOW, CA 923113056
Phone: (760) 256-1777
Fax: (760) 256-7766
Type: Location
801 E MOUNTAIN VIEW ST STE E
BARSTOW, CA 923113052
Phone: (760) 256-1777
Type: Location
Bonanza Road, Victorville, San Bernardino County, California, 92392-2403, United States
VICTORVILLE, CA 923922711
Phone: (760) 900-6411
Type: Mailing
303 E BUENA VISTA ST
BARSTOW, CA 923112803
Phone: (760) 241-4929
Fax: (760) 241-5950
Type: Mailing
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 $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-02-20 • Largest payer in this snapshot: Novo Nordisk Inc ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $19 |
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: 2020-01-15
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 |
|---|---|---|---|---|
| I20200115001604 | I | Family Practice | CA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 144 | 63 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 41 | 28 | $0 |
Insurance plans in this area (ZIP 92311)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| O P T O M E T R Y | CA | |
| Internal Medicine | HI | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Family Practice | CA | |
| Nurse Practitioner | CA |
Reviews
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