Deactivated NPI 1619962545 Deactivated / Inactive NPI Male Practitioner

Dr. Kevin James Blasingame , DO

Internal Medicine • Jackson, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kevin Blasingame has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 16, 2005

NPI Deactivation Date January 05, 2021

Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Kevin Blasingame, DO was a registered Internal Medicine practicing in Jackson, CA. Throughout an active medical career spanning 16 years, Dr. Blasingame provided care at the practice location at 665 NEW YORK RANCH RD until profile deactivation on 2021-01-05.

Historical Medicare Part B clinical services included established patient outpatient office visit, brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic, vaccine for influenza for administration into muscle, 0.5 ml dosage. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

665 New York Ranch Rd
Ste 4

Jackson, CA 956429331

Telephone 2092234700

Fax 2092313420

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Jackson, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 30.5 Yrs

State Avg: 26.6 Yrs

Regional Practice Density

14 Specialists

Practicing in Jackson, CA (18502 Statewide)

Telehealth Adoption Rate

35.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

43.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,119	433	$178.90	$113.87
99213 Established patient office or other outpatient visit, typically 15 minutes	903	311	$124.04	$78.46
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	400	219	$30.00	$15.13
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	199	197	$45.00	$19.17
G0008 Administration of influenza virus vaccine	198	196	$45.00	$17.68
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	97	27	$45.21	$15.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	97	20	$44.54	$1.48
J1885 Injection, ketorolac tromethamine, per 15 mg	73	12	$44.93	$0.55
20610 Aspiration and/or injection of fluid from large joint	27	20	$101.30	$68.41
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	26	19	$200.00	$111.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$257.04	$171.47
17000 Destruction of skin growth	17	15	$105.00	$69.60
69210 Removal of impacted ear wax	11	11	$75.07	$49.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,475	484	$164.83	$111.95
99213 Established patient office or other outpatient visit, typically 15 minutes	842	309	$112.68	$76.31
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	184	184	$45.00	$17.48
G0008 Administration of influenza virus vaccine	184	184	$45.00	$17.33
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	160	33	$39.75	$1.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	135	37	$40.00	$17.44
J1885 Injection, ketorolac tromethamine, per 15 mg	106	16	$30.19	$0.52
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	82	17	$30.00	$1.78
20610 Aspiration and/or injection of fluid from large joint	44	33	$92.56	$62.30
17000 Destruction of skin growth	29	24	$99.97	$68.06
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	27	21	$162.52	$110.55
69210 Removal of impacted ear wax	14	14	$71.61	$48.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,468	523	$154.35	$107.70
99213 Established patient office or other outpatient visit, typically 15 minutes	891	340	$105.02	$72.39
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	207	34	$30.29	$1.80
G0008 Administration of influenza virus vaccine	172	171	$40.00	$21.47
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	172	171	$30.28	$17.48
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	168	48	$37.76	$20.95
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	113	26	$30.00	$1.95
J1885 Injection, ketorolac tromethamine, per 15 mg	96	11	$30.00	$0.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	72	72	$232.88	$164.43
20610 Aspiration and/or injection of fluid from large joint	59	36	$89.74	$60.61
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	27	24	$154.36	$107.82
J1040 Injection, methylprednisolone acetate, 80 mg	21	18	$30.00	$12.90
17000 Destruction of skin growth	16	14	$96.77	$66.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,358	467	$147.96	$122.07
99213 Established patient office or other outpatient visit, typically 15 minutes	931	357	$105.01	$82.95
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	203	35	$25.76	$1.77
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	169	167	$31.69	$17.48
G0008 Administration of influenza virus vaccine	168	166	$47.35	$26.83
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	167	56	$35.86	$30.07
J1885 Injection, ketorolac tromethamine, per 15 mg	119	19	$26.18	$0.67
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	118	30	$26.27	$2.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	68	68	$223.36	$180.94
20610 Aspiration and/or injection of fluid from large joint	54	35	$87.28	$69.88
17003 Destruction of precancer skin growth, 2-14 growths	41	12	$7.83	$6.29
17000 Destruction of skin growth	32	26	$92.66	$73.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	20	$60.34	$50.66
69210 Removal of impacted ear wax	18	18	$67.92	$56.08
J1040 Injection, methylprednisolone acetate, 80 mg	15	14	$26.00	$11.05
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$230.52	$197.68
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	12	11	$150.36	$124.54

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License CA 20A6884

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Christopher Sienes , DC

Chiropractor

NPI 1508966334

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated January 05, 2021

Record deactivated on January 05, 2021

✅

NPI Profile Active December 21, 2009

NPI status registered as active in NPPES database

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Updated Practice Location December 21, 2009

Registered at 665 NEW YORK RANCH RD, STE 4, JACKSON, CA 956429331 (Tel: 2092234700)

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Updated Business Mailing Address December 21, 2009

Registered at 665 NEW YORK RANCH RD, STE 4, JACKSON, CA 956429331 (Tel: 2092234700)

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Provider Name / Credentials Updated December 21, 2009

Recorded as KEVIN BLASINGAME, D.O.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2009

Internal Medicine (License #20A6884 in CA)

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Initial NPI Registration & Enumeration September 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619962545

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 16, 2005

Last Update: December 21, 2009

Deactivation Date: January 05, 2021

Update or Correct Profile

Mailing Address

665 New York Ranch Rd, Ste 4

Jackson, CA 956429331

Phone: 2092234700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.