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KENNETH H. BALLENTINE OD INC.
NPI 1649448507
Eyewear Supplier in San Jose, CA

Active since February 13, 2008
5275 PROSPECT RD, SAN JOSE, CA 95129(408) 255-0576 Get Directions Write a Review

NPPES record last updated: September 6, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kenneth H. Ballentine Od Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH H. BALLENTINE OD INC. (NPI 1649448507) is a healthcare organization registered as an eyewear supplier in San Jose, California and active in the NPI registry since February 2008. The organization lists Kenneth H Ballentine, Doctor, as its authorized official.

NPPES Registry Identity

NPI1649448507
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameKENNETH H. BALLENTINE OD INC.
Location Address5275 PROSPECT RDSan Jose, CA 95129-5031
Mailing Address5275 Prospect RdSan Jose, CA 95129-5031 · (408) 255-0576
Phone(408) 255-0576
Organization SubpartNo
Authorized OfficialKenneth H BallentineDoctor · (408) 255-0576
Enumeration DateFebruary 13, 2008
Last NPPES UpdateSeptember 6, 2012
✔ NPI 1649448507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in CA · 6863T
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X · License 6863T (CA)
5275 PROSPECT RD, San Jose, CA 95129
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Other Identifiers 4

Medicare NSC0154770001CA
Medicare UPINT10429
MedicaidSD0068630CA
Medicare PINFS797A

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth H. Ballentine Od Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20120130000576Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kenneth H. Ballentine Od Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Kenneth Ballentine, O.D.
Optometry
NPI 1548230071
5275 PROSPECT RD
San Jose, CA 95129
(408) 255-0576
✔ PECOS0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth H. Ballentine Od Inc.'s NPI number?

The NPI number for Kenneth H. Ballentine Od Inc. is 1649448507. It was assigned to this organization in the NPPES registry on February 13, 2008.

Where is Kenneth H. Ballentine Od Inc. located?

Kenneth H. Ballentine Od Inc. is located at 5275 Prospect Rd, San Jose, CA 95129. The listed phone number is (408) 255-0576.

What is Kenneth H. Ballentine Od Inc.'s specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Is Kenneth H. Ballentine Od Inc. enrolled in Medicare?

Yes. Kenneth H. Ballentine Od Inc. is registered in the Medicare PECOS enrollment system.

When is Kenneth H. Ballentine Od Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Kenneth H. Ballentine Od Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Kenneth H. Ballentine Od Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth H. Ballentine Od Inc. was last updated on September 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.