KENNETH A. JONGSMA (D.O.) – Anesthesiology Physician, NPI 1245283209
Anesthesiology Physician
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NPPES metrics only — not quality of care.
1,447 ANESTHESIOLOGY in IN
Provider Addresses for KENNETH A. JONGSMA (D.O.)
5215 Holy Cross Pky
Mishawaka, IN 465451469
Phone: (574) 233-3123
Fax: (574) 233-3125
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
1701 N SENATE BLVD
INDIANAPOLIS, IN 462021239
Phone: (317) 731-0050
Fax: (317) 731-0050
Type: Location
South Bend Post Office, 313, South Main Street, South Bend, Young County, Texas, 76481, United States
SOUTH BEND, IN 466341742
Phone: (574) 233-3123
Fax: (574) 233-3125
Type: Mailing
Mishawaka Medical Center, 5215, Holy Cross Parkway, Mishawaka, Saint Joseph County, Indiana, 46545, United States
MISHAWAKA, IN 465451469
Phone: (574) 233-3123
Fax: (574) 233-3125
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: 2021-09-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20060713000138 | I | Anesthesiology | IN | TBD |
| I20210914003160 | I | Anesthesiology | MI | 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 |
|---|---|---|---|---|
| 00812 | Anesthesia for exam of colon using an endoscope | 27 | 27 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 19 | 18 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 46545)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | ND | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| - | IL | |
| A N E S T H E S I O L O G Y | WI |
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