DR. KIMBERLY BLAKE (M.D.) – Obstetrics & Gynecology Physician, NPI 1265480222
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
120 OBSTETRICS/GYNECOLOGY in VT
Provider Addresses for DR. KIMBERLY BLAKE (M.D.)
75 San Remo Dr
South Burlington, VT 054036385
Phone: (802) 488-6000
Fax: (802) 488-6919
Type: Location
855 Pine St
Burlington, VT 054014924
Phone: (802) 488-6000
Type: Location
75 Beekman St
Plattsburgh, NY 129011438
Phone: (518) 561-2000
Type: Location
96, Colchester Avenue, Burlington, Chittenden County, Vermont, 05404, United States
BURLINGTON, VT 054011417
Phone: (802) 658-0505
Type: Mailing
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: 2020-02-12
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 |
|---|---|---|---|---|
| I20060327000511 | I | Obstetrics/Gynecology | VT | TBD |
| I20200212002087 | I | Obstetrics/Gynecology | NY | 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 |
|---|---|---|---|---|
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 27 | 27 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 19 | 15 | $0 |
Insurance plans in this area (ZIP 05403)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OBSTETRICS/GYNECOLOGY | VT | 76830 | Ultrasound pelvis through vagina | 16 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| Nurse Practitioner | MA | |
| - | VT | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| - | VT | |
| - | VT | |
| - | CT | |
| - | VT | |
| - | IN | |
| - | VT |
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