Individual provider Active NPI

Kurt Blickenstaff, M.D.

  • Surgery Physician
  • Ventura, CA
National Provider Identifier
1437212453
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G57756 Issued in CA
Practice address
3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone
(805) 641-4431
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G57756 CA Primary

Addresses

Primary practice location

3291 Loma Vista Rd
Ventura, CA 93003-3099

Mailing address

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 641-4431

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kurt.blickenstaff@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000861 CA Practitioner - General Surgery 4486788635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Utah School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
64.51
Promoting interoperability
100
Improvement activities
40
Cost
72.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neal P. Dixon, M.D., a General Surgical Medical Corporation Surgery Current Accepting new patients
County of Ventura CurrentSince Jul 11, 2017 Accepting new patients
Ventura County Surgical Associates Surgery CurrentSince Nov 1, 2020 Accepting new patients
County of Ventura CurrentSince Jul 11, 2017 Accepting new patients
County of Ventura Current Accepting new patients

Locations

2438 N Ponderosa Dr
Ste C207
Camarillo, CA 93010
Phone (805) 484-3513

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

3291 Loma Vista Rd
Bldg 340
Ventura, CA 93003
Phone (805) 652-6218

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

3291 Loma Vista Rd
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1437212453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-641-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-641-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKENSTAFF",
        "first_name": "KURT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G57756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kurt.blickenstaff@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "3291 Loma Vista Rd",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930033099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.