KENNETH D BLAKE (MD) – Colon & Rectal Surgery Physician, NPI 1174622070
Colon & Rectal Surgery Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
28 COLORECTAL SURGERY (PROCTOLOGY) in CO
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Provider Addresses for KENNETH D BLAKE (MD)
Wells Fargo, 3333, South Bannock Street, Englewood, Arapahoe County, Colorado, 80113-1525, United States
SUITE 350
ENGLEWOOD, CO 801102432
Phone: (303) 957-1310
Fax: (303) 761-4252
Type: Mailing
10103, RidgeGate Parkway, Lone Tree, Douglas County, Colorado, 80124, United States
SUITE 208
LONE TREE, CO 801245520
Phone: (303) 535-5350
Fax: (303) 535-5353
Type: Location
8490 E CRESCENT PKWY STE 380
GREENWOOD VILLAGE, CO 801112815
Phone: (303) 957-1310
Fax: (303) 761-4252
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $1,606.
Total Amount is formed as General ($1,606) + Research ($0) + Ownership ($0) = $1,606.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Axonics, Inc. ($612).
Total Amount
$1,606
General + Research + Ownership
Payments
26
Total payment records
General Amount
$1,606
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $612 |
| Medtronic, Inc. | $270 |
| Intuitive Surgical, Inc. | $266 |
| Davol Inc. | $195 |
| Integra LifeSciences Corporation | $60 |
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: 2004-07-16
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 |
|---|---|---|---|---|
| I20040716000032 | I | Colorectal Surgery (Proctology) | CO | 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 |
|---|---|---|---|---|
| 46600 | Diagnostic exam of anus using an endoscope | 56 | 46 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 26 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 28 | 27 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 26 | 11 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 17 | 14 | $0 |
Insurance plans in this area (ZIP 80110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | CO | |
| O T O L A R Y N G O L O G Y | CO | |
| - | CO | |
| General Surgery | CO | |
| - | CO | |
| General Surgery, Surgical Oncology | CO | |
| O T O L A R Y N G O L O G Y | CO | |
| U R O L O G Y | CA | |
| Physician Assistant | GA | |
| Physician Assistant | CO |
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