LIA R KETTENIS (M.D.) – Child & Adolescent Psychiatry Physician, NPI 1346459146
Child & Adolescent Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
528 PSYCHIATRY in IN
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Provider Addresses for LIA R KETTENIS (M.D.)
645 S ROGERS ST
BLOOMINGTON, IN 474032353
Phone: (812) 269-5092
Type: Mailing
550, South Adams Street, Bloomington, Monroe County, Indiana, 47403, United States
BLOOMINGTON, IN 474032165
Phone: (812) 333-6324
Fax: (812) 331-6700
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $1,886.
Total Amount is formed as General ($1,886) + Research ($0) + Ownership ($0) = $1,886.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($268).
Total Amount
$1,886
General + Research + Ownership
Payments
77
Total payment records
General Amount
$1,886
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2007-09-19
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 |
|---|---|---|---|---|
| I20070919000477 | I | Psychiatry | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47403)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | IN | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 51 | 37 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| P S Y C H I A T R Y | IN | |
| - | IN | |
| Psychiatry, Addiction Medicine | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Internal Medicine | IN |
Reviews
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