KAHNI C BLACKMON (PHD) – Psychiatry Physician, NPI 1902177884

KAHNI C BLACKMON (PHD) is a healthcare provider. based in Revere, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PSY-9439 (MA). The NPI Number for KAHNI C BLACKMON (PHD) is 1902177884

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
KAHNI C BLACKMON (PHD)
NPI
1902177884
Phone
(781) 485-6180
Address
MGH REVERE HEALTHCARE CENTER
Enumeration Date
24 January 2012
Last Update Date
24 January 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7814851000
Graduation Year
2008 (18 years ago)
PAC ID
1951561240
Group Practice PAC ID
6507803806
Professional Enrollment ID
I20120323000215
Address ID
MA021513033RE385XXBROA200
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

Provider Addresses for KAHNI C BLACKMON (PHD)

  • MGH REVERE HEALTHCARE CENTER

    300 OCEAN AVE.

    REVERE, MA 02151

    Phone: (781) 485-6180

    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)

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: 2012-03-23

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
I20120323000215IClinical PsychologistMATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes16716$0
View full utilization report →

Insurance plans in this area (ZIP 02151)

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Provider's Procedures

KAHNI C BLACKMON (PHD) performs procedures in CLINICAL PSYCHOLOGIST. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHOLOGIST, CLINICALMA90853Group psychotherapy14116

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: 6507803806View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMA
Internal MedicineMA
-MA
-MA
Anesthesiology, Pain ManagementMA
-MA
Clinical PsychologistMA
Internal MedicineMA
Internal MedicineMA
-MA

Reviews

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Frequently asked questions

Does KAHNI C BLACKMON (PHD) have a public NPI I can cite?
Public records show KAHNI C BLACKMON (PHD) under NPI 1902177884.
Is KAHNI C BLACKMON (PHD)'s NPI status active today?
Active status means KAHNI C BLACKMON (PHD)'s NPI record is not deactivated in the public file.
What services align with KAHNI C BLACKMON (PHD)'s listing?
KAHNI C BLACKMON (PHD)'s public classification highlights Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is KAHNI C BLACKMON (PHD) tied to Revere, Massachusetts?
If you are local to Revere, Massachusetts, KAHNI C BLACKMON (PHD) may be relevant to your search.
Can I export KAHNI C BLACKMON (PHD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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