MALLORY C BLANKENBERGER (PA-C) – Physician Assistant, NPI 1104348044
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
2,510 PHYSICIAN ASSISTANT in IN
Provider Addresses for MALLORY C BLANKENBERGER (PA-C)
705 Riley Hospital Dr
Indianapolis, IN 462025109
Phone: (317) 944-3636
Fax: (317) 968-1372
Type: Location
1801 N Senate Blvd
Indianapolis, IN 462021228
Phone: (317) 944-3636
Fax: (317) 968-1372
Type: Location
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (888) 484-3258
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
5165 MCCARTY LANE
LAFAYETTE, IN 479058764
Phone: (800) 899-8448
Type: Location
5165 MCCARTY LN
LAFAYETTE, IN 479058764
Phone: (800) 899-8448
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 47 Open Payments records for all available years, with a total value of $670.
Total Amount is formed as General ($670) + Research ($0) + Ownership ($0) = $670.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Inari Medical, Inc. ($644).
Total Amount
$670
General + Research + Ownership
Payments
47
Total payment records
General Amount
$670
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $644 |
| Smith+Nephew, Inc. | $26 |
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: 2017-07-25
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20170725000571 | I | Physician Assistant | IN | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 148 | 145 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 63 | 61 | $0 |
| 99291 | Critical care, first 30-74 minutes | 21 | 21 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 18 | 18 | $0 |
Insurance plans in this area (ZIP 46202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Physician Assistant | IN | |
| Nurse Practitioner | IN | |
| Plastic And Reconstructive Surgery | IN | |
| Physician Assistant | IN | |
| Thoracic Surgery | OH | |
| Plastic And Reconstructive Surgery, General Surgery, Hand Surgery | IN | |
| Plastic And Reconstructive Surgery | IN | |
| Nurse Practitioner | IN | |
| General Surgery | OH |
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