BRAD D. BLANKENHORN M.D.
NPI 1003033119
Orthopaedic Surgery in East Providence, RI

Q: What is Brad Blankenhorn's NPI number?

The NPI number for Brad Blankenhorn is 1003033119. It was assigned to this individual provider in the NPPES registry on April 19, 2007.

Q: What is Brad Blankenhorn's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Brad Blankenhorn was last updated on February 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since April 19, 2007PECOS EnrolledAccepts Medicare Assignment

75.39/100

CMS Quality Rating

1 KETTLE POINT AVE, EAST PROVIDENCE, RI 02914(401) 330-1405(401) 277-0799 Get Directions Write a Review

NPPES record last updated: February 14, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Brad D. Blankenhorn M.d. NPPES

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

BRAD D. BLANKENHORN M.D. (NPI 1003033119) is an individual orthopaedic surgery provider in East Providence, Rhode Island, licensed in Rhode Island (MD13206) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of University Of Pittsburgh School Of Medicine (2005).

NPPES Registry Identity

NPI1003033119

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameBRAD D. BLANKENHORNCredential: M.D.

Location Address1 KETTLE POINT AVEEast Providence, RI 02914-5375

Mailing AddressPo Box 1119Providence, RI 02901-1119 · (401) 330-1405 · Fax (401) 277-0799

Phone(401) 330-1405

Fax(401) 277-0799

Sole ProprietorYes

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2005

Enumeration DateApril 19, 2007

Last NPPES UpdateFebruary 14, 2019

✔ NPI 1003033119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in RI · MD13206✔ Licensed in NM · 2012-0546

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1 KETTLE POINT AVE, East Providence, RI 02914

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Other Identifiers 2

Other110087299ARI · Masshealth

MedicaidBB81009RI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brad D. Blankenhorn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749311801

PECOS Enrollment IDI20100706000637, I20220324001219

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

320 services229 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

263 services198 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

167 services111 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

112 services94 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

40 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

22 services22 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rhode Island Hospital

Acute Care Hospitals · Providence, RI

3/5 CMS rating

OwnershipTribal

CMS Certification Number410007

Location593 Eddy StreetProvidence, RI 02903 · Providence County

Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410012

Location164 Summit AvenueProvidence, RI 02906 · Providence County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02914 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.48 typical visit price

range $58.57 – $177.03

Typical copayment $22.62 (range $14.64 – $44.25)

Most-billed visit code 99203

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

59.78

Promoting Interoperability

Improvement Activities

Cost

62.35

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

35%567 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

97%3,376 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

12%609 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

24%2,134 patients1/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 90% · 1,508 patients

Patients screened: 99% · 1,508 patients

20%168 patients1/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

66%820 patients3/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 669 patients

Patients totalRate: 2% · 670 patients

2%670 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf L1902

DME-Orthotic Devices · category DF003N

2 suppliers12 claims12 services$71.66 avg. paid by Medicare

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361

DME-Orthotic Devices · category DF003N

2 suppliers23 claims23 services$269.00 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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