JASON MATTHEW BLOCKSOM (MD) – Plastic and Reconstructive Surgery Physician, NPI 1144488495

JASON MATTHEW BLOCKSOM (MD) is a healthcare provider. based in Indianapolis, Indiana. specializing in Plastic and Reconstructive Surgery Physician. They hold the professional credentials MD. They hold a License No. 01068126A (IN). The NPI Number for JASON MATTHEW BLOCKSOM (MD) is 1144488495

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
JASON MATTHEW BLOCKSOM (MD)
NPI
1144488495
Phone
Not provided
Address
10330 N MERIDIAN ST
Enumeration Date
22 May 2008
Last Update Date
25 May 2022

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3173383617
Graduation Year
1999 (27 years ago)
PAC ID
2062559297
Group Practice PAC ID
1557313939
Professional Enrollment ID
I20100625000335

Contacts

Secure Messaging
jason.blocksom.2@7598.direct.athenahealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

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Provider Addresses for JASON MATTHEW BLOCKSOM (MD)

  • North Meridian Street, Spring Mill Woods, Indianapolis, Indiana, 46074:46260, United States

    SUITE 201

    INDIANAPOLIS, IN 462901024

    Phone:

    Type: Mailing

  • 8402 HARCOURT RD STE 830

    INDIANAPOLIS, IN 462602096

    Phone:

    Type: Mailing

  • 8402, Harcourt Road, Indianapolis, Indiana, 46260, United States

    INDIANAPOLIS, IN 462602074

    Phone: (317) 338-6713

    Fax: (317) 338-6615

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-06-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100625000335IGeneral SurgeryINTBD

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.

Verify on CMS Revalidation Lookup Tool

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 46290)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557313939View full group profile
NameSpecialtyState
Pediatric MedicineIN
O B S T E T R I C S/ G Y N E C O L O G YOH
Nurse PractitionerKY
Pediatric MedicineIN
O B S T E T R I C S/ G Y N E C O L O G YIL
H E M A T O L O G Y/ O N C O L O G YIN
O B S T E T R I C S/ G Y N E C O L O G YWA
Nurse PractitionerIN
Otolaryngology, Pediatric MedicineIN
Gastroenterology, Pediatric MedicineIN

Reviews

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Frequently asked questions

How do I look up JASON MATTHEW BLOCKSOM (MD) by NPI?
Use NPI 1144488495 when you need to reference JASON MATTHEW BLOCKSOM (MD) in forms, claims, or directories.
Is JASON MATTHEW BLOCKSOM (MD) active in the national directory?
JASON MATTHEW BLOCKSOM (MD)'s public NPI profile is in an active state.
What kind of provider is JASON MATTHEW BLOCKSOM (MD)?
The page reflects Plastic and Reconstructive Surgery Physician for JASON MATTHEW BLOCKSOM (MD). Clinical services aligned with this taxonomy classification.
Where does public data place JASON MATTHEW BLOCKSOM (MD)?
The snapshot lists Indianapolis, Indiana for JASON MATTHEW BLOCKSOM (MD); download NPPES for the complete set.
How can I contact JASON MATTHEW BLOCKSOM (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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