DR. CLAYTON GREGG BLEHM MD
NPI 1235127713
Ophthalmology in Gainesville, GA

Active since October 10, 2005PECOS EnrolledAccepts Medicare Assignment
90.64/100
CMS Quality Rating
2061 BEVERLY RD, GAINESVILLE, GA 30501(770) 532-4444(770) 535-1852 Get Directions Write a Review

NPPES record last updated: March 30, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Clayton Gregg Blehm Md NPPES

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

DR. CLAYTON GREGG BLEHM MD (NPI 1235127713) is an individual ophthalmology provider in Gainesville, Georgia, licensed in Georgia (059602) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Union General Hospital, and is a graduate of University Of Texas Medical School At Houston (2001).

NPPES Registry Identity

NPI1235127713
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. CLAYTON GREGG BLEHMCredential: MD
Location Address2061 BEVERLY RDGainesville, GA 30501-2034
Mailing Address2061 Beverly RdGainesville, GA 30501-2034 · (770) 532-4444 · Fax (770) 535-1852
Fax(770) 535-1852
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 2001
Enumeration DateOctober 10, 2005
Last NPPES UpdateMarch 30, 2016
NPI 1235127713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in GA · 059602 Licensed in NC · 200500892
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
2061 BEVERLY RD, Gainesville, GA 30501

Other Identifiers 5

Medicare PINGRP565GA
Medicaid817261230AGA
Medicaid5901302NC
Medicare UPINI35941
Medicare PIN2347887NC

Accepted 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

Dr. Clayton Gregg Blehm Md 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 ID3678502705
PECOS Enrollment IDI20050809001037, I20080604000194
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.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
633 services367 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
408 services408 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.
380 services380 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.
358 services350 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
198 services197 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.
186 services163 patients

Hospital Affiliations CMS Care Compare 2

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

Union General Hospital

Acute Care Hospitals · Blairsville, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110051
Location35 Hospital RoadBlairsville, GA 30512 · Union County
Emergency services Birthing friendly

Erlanger Murphy Medical Center

Critical Access Hospitals · Murphy, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number341328
Location3990 East Us Highway 64 AltMurphy, NC 28906 · Cherokee County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
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.

90.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost68.82

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
68%268 patients3/55-star benchmark: 100%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
90%1,696 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%134 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%4,248 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%4,439 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
2%1,583 patients1/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
97%4,249 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%3,139 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
82%1,696 patients4/55-star benchmark: 95%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
99%806 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
96%3,139 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%3,139 patients1/55-star benchmark: 79%
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 15

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

Clinic/Center (Ambulatory Surgical)
2061 BEVERLY RD
GAINESVILLE, GA 30501
Ophthalmology
2061 BEVERLY RD
GAINESVILLE, GA 30501
Ophthalmology
2061 BEVERLY RD
GAINESVILLE, GA 30501
Optometrist
2061 BEVERLY RD
GAINESVILLE, GA 30501
Optometrist
2061 BEVERLY RD
GAINESVILLE, GA 30501
Ophthalmology
2061 BEVERLY RD
GAINESVILLE, GA 30501
Ophthalmology
2061 BEVERLY RD
GAINESVILLE, GA 30501
Optometrist
2061 BEVERLY RD
GAINESVILLE, GA 30501

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 Clayton Blehm's NPI number?

The NPI number for Clayton Blehm is 1235127713. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Clayton Blehm located?

Clayton Blehm practices at 2061 Beverly Rd, Gainesville, GA 30501. The listed phone number is (770) 532-4444.

What is Clayton Blehm's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Clayton Blehm enrolled in Medicare?

Yes. Clayton Blehm is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Clayton Blehm accept?

Health plans from Alliant Health Plans, Inc., AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC list Clayton Blehm as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Clayton Blehm affiliated with any hospitals?

According to CMS data, Clayton Blehm is affiliated with Union General Hospital and Erlanger Murphy Medical Center.

When was this NPI record last updated?

The NPPES record for Clayton Blehm was last updated on March 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.