ANTHONY PAUL BLALOCK M.D.
NPI 1124037726
Internal Medicine - Nephrology in Lafayette, LA

Q: What is Anthony Blalock's NPI number?

The NPI number for Anthony Blalock is 1124037726. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Q: What is Anthony Blalock's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Blalock was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 August 05, 2006PECOS EnrolledAccepts Medicare Assignment

2804 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506(337) 981-5156(337) 981-0673 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Anthony Paul Blalock M.d. NPPES

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

ANTHONY PAUL BLALOCK M.D. (NPI 1124037726) is an individual nephrology provider in Lafayette, Louisiana, licensed in Louisiana (024394) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Ochsner Lafayette General Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (2003).

NPPES Registry Identity

NPI1124037726

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameANTHONY PAUL BLALOCKCredential: M.D.

Location Address2804 AMBASSADOR CAFFERY PKWYLafayette, LA 70506-5906

Mailing Address300 W Saint Mary BlvdLafayette, LA 70506-4638 · (337) 233-6593 · Fax (337) 235-1032

Phone(337) 981-5156

Fax(337) 981-0673

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2003

Enumeration DateAugust 5, 2006

Last NPPES UpdateJuly 24, 2024

NPPES CertifiedMarch 22, 2024

✔ NPI 1124037726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in LA · 024394

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

2804 AMBASSADOR CAFFERY PKWY, Lafayette, LA 70506

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Other Identifiers 1

Medicaid1489131LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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

Anthony Paul Blalock 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 ID1658316815

PECOS Enrollment IDI20050628000447

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 15

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

920 services312 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

435 services68 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.

393 services173 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

275 services233 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

211 services123 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

138 services64 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

110 services74 patients

Dialysis services, per day, less than full month service (20 years or older) 90970

Dialysis is a treatment that replicates some functions of healthy kidneys when they're not working properly. It helps to remove waste, salt, and excess water from your body and maintain a safe level of certain chemicals in your blood. This service, for patients aged 20 or older, is provided on a daily basis for less than a full month.

99 services11 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

80 services59 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.

36 services31 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

32 services32 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

30 services21 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

26 services26 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

26 services26 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.

22 services22 patients

Hospital Affiliations CMS Care Compare 5

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

Ochsner Lafayette General Medical Center

Acute Care Hospitals · Lafayette, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190002

Location1214 Coolidge AvenueLafayette, LA 70503 · Lafayette County

Emergency services Birthing friendly

Opelousas General Health System

Acute Care Hospitals · Opelousas, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number190017

Location539 East Prudhomme StreetOpelousas, LA 70570 · St. Landry County

Emergency services Birthing friendly

Ochsner American Legion Hospital

Acute Care Hospitals · Jennings, LA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190053

Location1634 Elton RoadJennings, LA 70546 · Jeffrson Davis County

Emergency services Birthing friendly

Our Lady Of Lourdes Regional Medical Center, Inc

Acute Care Hospitals · Lafayette, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190102

Location4801 Ambassador Caffery ParkwayLafayette, LA 70508 · Lafayette County

Emergency services Birthing friendly

Ochsner St Martin Hospital

Critical Access Hospitals · Breaux Bridge, LA

OwnershipVoluntary non-profit - Private

CMS Certification Number191302

Location210 Champagne BoulevardBreaux Bridge, LA 70517 · St. Martin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70506 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

$124.60 typical visit price

range $53.43 – $164.73

Typical copayment $31.15 (range $13.35 – $41.18)

Most-billed visit code 99204

Established Patient

$95.09 typical visit price

range $16.64 – $133.62

Typical copayment $23.77 (range $4.16 – $33.40)

Most-billed visit code 99214

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.

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

76%33 patients4/55-star benchmark: 100%

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%43 patients5/55-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.

Other Providers at the Same Location NPPES 5

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

DR. RODERICK V. CLARK M.D.

Internal Medicine (Nephrology)