KYLE MATTHEW BALTRUSCH (MD) – Plastic and Reconstructive Surgery Physician, NPI 1952741779
Plastic and Reconstructive Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
70 PLASTIC AND RECONSTRUCTIVE SURGERY in OR
Provider Addresses for KYLE MATTHEW BALTRUSCH (MD)
3181 SW SAM JACKSON PARK RD
L-579
PORTLAND, OR 972393011
Phone: (503) 494-8220
Type: Mailing
1200 NW NAITO PKWY STE 310
PORTLAND, OR 972092829
Phone: (503) 292-9200
Fax: (503) 292-9205
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $1,193.
Total Amount is formed as General ($1,193) + Research ($0) + Ownership ($0) = $1,193.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($383).
Total Amount
$1,193
General + Research + Ownership
Payments
18
Total payment records
General Amount
$1,193
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $383 |
| Mentor Worldwide LLC | $382 |
| MOTIVA USA, LLC | $240 |
| Integra LifeSciences Corporation | $174 |
| Baxter Healthcare | $13 |
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: 2021-07-26
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 |
|---|---|---|---|---|
| I20210726000451 | I | Plastic And Reconstructive Surgery | OR | 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 97239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Physician Assistant | OR | |
| Plastic And Reconstructive Surgery | OR | |
| Plastic And Reconstructive Surgery | OR |
Reviews
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