KAELAN DENDY YOUNG BLACK (M.D.) – Pediatric Otolaryngology Physician, NPI 1215226469
Pediatric Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
732 OTOLARYNGOLOGY in FL
Provider Addresses for KAELAN DENDY YOUNG BLACK (M.D.)
12901 BRUCE B DOWNS BLVD
MDC 41
TAMPA, FL 336124742
Phone: (813) 844-7995
Type: Location
3801 UNIVERSITY DR
STE 200
FAIRFAX, VA 220302503
Phone: (703) 383-8130
Fax: (703) 383-7353
Type: Mailing
3801 UNIVERSITY DR STE 300
FAIRFAX, VA 220302503
Phone: (703) 383-8130
Fax: (703) 383-7350
Type: Location
501 N Graham St Ste 585
Portland, OR 972271654
Phone: (503) 413-3690
Type: Location
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 $41.
Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.
Last reported payment date: 2024-06-06 • Largest payer in this snapshot: Medtronic, Inc. ($41).
Total Amount
$41
General + Research + Ownership
Payments
1
Total payment records
General Amount
$41
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $41 |
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: 2025-01-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20171117002185 | I | Otolaryngology | DC | TBD |
| I20171204002410 | I | Otolaryngology | VA | TBD |
| I20250116003757 | I | Pediatric Medicine | OR | 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 | 40 | 36 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 32 | 28 | $0 |
| 69210 | Removal of impacted ear wax | 26 | 25 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 33612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Otolaryngology, Plastic And Reconstructive Surgery | VA | |
| O T O L A R Y N G O L O G Y | VA | |
| Physician Assistant | VA | |
| Physician Assistant | VA | |
| O T O L A R Y N G O L O G Y | MO | |
| Qualified Audiologist | VA | |
| Qualified Audiologist | VA | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | VA | |
| O T O L A R Y N G O L O G Y | PA |
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