PHILLIP R KINGMA (M.D.) – Interventional Pain Medicine Physician, NPI 1629038419
Interventional Pain Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
67 INTERVENTIONAL PAIN MANAGEMENT in IN
Provider Addresses for PHILLIP R KINGMA (M.D.)
12289 HANCOCK ST STE 34
CARMEL, IN 460325888
Phone: (317) 815-8950
Fax: (317) 815-8951
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 52 Open Payments records for all available years, with a total value of $1,236.
Total Amount is formed as General ($1,236) + Research ($0) + Ownership ($0) = $1,236.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Vertos Medical, Inc. ($560).
Total Amount
$1,236
General + Research + Ownership
Payments
52
Total payment records
General Amount
$1,236
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Vertos Medical, Inc. | $560 |
| Abbott Laboratories | $518 |
| PAINTEQ LLC | $72 |
| Saluda Medical Americas, Inc. | $40 |
| Boston Scientific Corporation | $29 |
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: 2007-07-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070725000198 | I | Interventional Pain Management | 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 |
|---|---|---|---|---|
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 982 | 88 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 667 | 62 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 544 | 164 | $0 |
| 64636 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint | 143 | 40 | $0 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 137 | 78 | $0 |
Insurance plans in this area (ZIP 46032)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
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