KENNETH WAYNE BLUMENTHAL (DO) – Family Medicine Physician, NPI 1427053255
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
78 ALLERGY/IMMUNOLOGY in IN
Provider Addresses for KENNETH WAYNE BLUMENTHAL (DO)
2802 LEONARD DR
VALPARAISO, IN 463837136
Phone: (219) 531-5855
Fax: (219) 531-1617
Type: Location
3125, Willowcreek Road, Portage, Porter County, Indiana, 46368, United States
PORTAGE, IN 463684423
Phone: (219) 762-3175
Fax: (219) 763-3092
Type: Mailing
6050 Sterling Creek Rd
Portage, IN 463687752
Phone: (219) 756-6100
Type: Location
11039 Broadway Ste B
Crown Point, IN 463077771
Phone: (219) 756-6100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 100 Open Payments records for all available years, with a total value of $1,689.
Total Amount is formed as General ($1,689) + Research ($0) + Ownership ($0) = $1,689.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($441).
Total Amount
$1,689
General + Research + Ownership
Payments
100
Total payment records
General Amount
$1,689
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $441 |
| Regeneron Healthcare Solutions, Inc. | $300 |
| GlaxoSmithKline, LLC. | $271 |
| GENZYME CORPORATION | $178 |
| Amgen Inc. | $58 |
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: 2009-12-03
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 |
|---|---|---|---|---|
| I20091203000757 | I | Allergy/Immunology | 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 |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 767 | 14 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 435 | 13 | $0 |
| 95117 | Professional service for multiple injections of allergen | 240 | 26 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 228 | 117 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 111 | 15 | $0 |
Insurance plans in this area (ZIP 46383)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ALLERGY/IMMUNOLOGY | IN | 95004 | Injection of allergenic extracts into skin, accessed through the skin | 990 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| A L L E R G Y/ I M M U N O L O G Y | IN | |
| Nurse Practitioner | NV | |
| Qualified Speech Language Pathologist | IN |
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