DAVID MICHAEL II BLACKWELL (MD) – Family Medicine Physician, NPI 1104903111
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,861 FAMILY PRACTICE in IN
Provider Addresses for DAVID MICHAEL II BLACKWELL (MD)
2625 E 62nd St Ste 2010
Indianapolis, IN 462200037
Phone: (317) 216-2800
Fax: (317) 216-2777
Type: Location
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (888) 484-3258
Type: Location
907, North East Street, Massachusetts Avenue Commercial District, Chatham-Arch, Indianapolis, Marion County, Indiana, 46202, United States
INDIANAPOLIS, IN 462023425
Phone: (317) 644-3461
Fax: (317) 602-2654
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $30.
Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.
Last reported payment date: 2023-10-06 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($16).
Total Amount
$30
General + Research + Ownership
Payments
2
Total payment records
General Amount
$30
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $16 |
| ABBVIE INC. | $14 |
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: 2005-04-04
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 |
|---|---|---|---|---|
| I20050404000872 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 119 | 53 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 49 | 49 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 42 | 33 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 27 | 27 | $0 |
| G0009 | Administration of pneumococcal vaccine | 26 | 26 | $0 |
Insurance plans in this area (ZIP 46220)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | IN | |
| Family Practice, Sports Medicine | IN | |
| - | IN | |
| - | IN | |
| - | IN | |
| - | IN | |
| - | IN | |
| - | CT | |
| - | IN | |
| P A T H O L O G Y | IN |
Reviews
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