DR. JEAN-LUC KALONDA KABANGU (MD) – Neurological Surgery Physician, NPI 1225529191
Neurological Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
183 NEUROSURGERY in TN
Provider Addresses for DR. JEAN-LUC KALONDA KABANGU (MD)
5124 SHELLY RAY RD # 5124
FORT WORTH, TX 762449229
Phone: (817) 938-3037
Type: Mailing
6325 Humphreys Blvd
Memphis, TN 381202300
Phone: (901) 522-7700
Fax: (901) 522-2600
Type: Location
6325 HUMPHREYS BLVD
MEMPHIS, TN 381202300
Phone: (901) 522-7700
Fax: (901) 522-2600
Type: Mailing
University of Kansas Medical Center, 3901, Rainbow Boulevard, Kansas City, Wyandotte County, Kansas, 66160, United States
KANSAS CITY, KS 661608500
Phone: (913) 588-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $89.
Total Amount is formed as General ($89) + Research ($0) + Ownership ($0) = $89.
Last reported payment date: 2023-11-14 • Largest payer in this snapshot: Medtronic, Inc. ($89).
Total Amount
$89
General + Research + Ownership
Payments
1
Total payment records
General Amount
$89
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $89 |
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: 2025-05-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20250410002253 | I | Neurosurgery | MS | TBD |
| I20250529002751 | I | Neurosurgery | TN | 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 76244)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | TN | |
| Nurse Practitioner | TN | |
| Physical Therapist In Private Practice | TN | |
| N E U R O L O G Y | TN | |
| Physician Assistant | TN | |
| N E U R O L O G Y | TN | |
| Anesthesiology, Pain Management, Interventional Pain Management | MS | |
| N E U R O S U R G E R Y | TN | |
| N E U R O S U R G E R Y | MS | |
| Physical Medicine And Rehabilitation | TN |
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