KELLY BLAKE CANTU (PA-C) – Pain Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1174718738
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,244 PHYSICIAN ASSISTANT in CT
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Provider Addresses for KELLY BLAKE CANTU (PA-C)
Hartford Hospital, 80, Seymour Street, Frog Hollow Historic District, Hartford, Hartford County, Connecticut, 06102, United States
HARTFORD HOSPITAL SURGERY DEPT.
HARTFORD, CT 061025037
Phone: (860) 972-4670
Type: Mailing
2000 CENTER POINT RD STE 2360
COLUMBIA, SC 292105826
Phone: (803) 233-5500
Fax: (803) 258-6395
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $272.
Total Amount is formed as General ($272) + Research ($0) + Ownership ($0) = $272.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Ferring Pharmaceuticals Inc. ($163).
Total Amount
$272
General + Research + Ownership
Payments
12
Total payment records
General Amount
$272
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2025-09-26
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 |
|---|---|---|---|---|
| I20250926003508 | I | Physician Assistant | SC | 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 06102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology, Interventional Radiology, Interventional Radiology, Diagnostic Radiology | NY | |
| Emergency Medicine | SC |
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