DR. JOSEPH HENRY IV DANNENBAUM (M.D.) – Adult Reconstructive Orthopaedic Surgery Physician, NPI 1386943777
Adult Reconstructive Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
505 ORTHOPEDIC SURGERY in KY
Provider Addresses for DR. JOSEPH HENRY IV DANNENBAUM (M.D.)
9040 JACKSON AVE
TACOMA, WA 984310001
Phone: (253) 968-1484
Type: Mailing
105 Keeton Dr
Hopkinsville, KY 422408756
Phone: (127) 088-9070
Type: Location
650 Joel Dr
Fort Campbell, KY 422235318
Phone: (270) 798-8426
Type: Location
125 Parker Hill Ave
Boston, MA 021202847
Phone: (617) 754-6742
Type: Location
125 PARKER HILL AVE
BOSTON, MA 021202847
Phone: (617) 754-6742
Type: Location
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: 2024-11-11
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 |
|---|---|---|---|---|
| I20201026001759 | I | Orthopedic Surgery | SD | TBD |
| I20241111000303 | I | Orthopedic Surgery | ID | 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 98431)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | CA | |
| General Surgery | PA | |
| General Surgery | OK | |
| Vascular Surgery, Thoracic Surgery, General Surgery | MI | |
| General Surgery | MO | |
| Orthopedic Surgery | NY | |
| Physician Assistant | VA | |
| Nurse Practitioner | MI | |
| Orthopedic Surgery | CA | |
| - | CA |
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