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ANDREW BLAKLEY
NPI 1255790051
Internal Medicine in Somerset, KY

Active since February 22, 2016PECOS EnrolledAccepts Medicare Assignment
85.61/100
CMS Quality Rating
350 HOSPITAL WAY, SUITE 101, SOMERSET, KY 42503(606) 451-5093 Get Directions Write a Review

NPPES record last updated: June 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrew Blakley NPPES

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

ANDREW BLAKLEY (NPI 1255790051) is an individual internal medicine provider in Somerset, Kentucky, licensed in Kentucky (04364) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, is affiliated with Lake Cumberland Regional Hospital, and is a graduate of Lincoln Memorial University Medical Department (2016).

NPPES Registry Identity

NPI1255790051
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameANDREW BLAKLEY
Location Address350 HOSPITAL WAY, SUITE 101Somerset, KY 42503-2872
Mailing Address350 Hospital Way, Suite 101Somerset, KY 42503-2872
Phone(606) 451-5093
Sole ProprietorNo
Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2016
Enumeration DateFebruary 22, 2016
Last NPPES UpdateJune 26, 2019
✔ NPI 1255790051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 04364
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
350 HOSPITAL WAY, Somerset, KY 42503
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter 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

Andrew Blakley 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 ID3678800182
PECOS Enrollment IDI20190806004350
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 6

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 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.
186 services85 patients
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.
127 services57 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
112 services108 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.
71 services70 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.
24 services24 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Lake Cumberland Regional Hospital

Acute Care Hospitals · Somerset, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180132
Location305 Langdon StreetSomerset, KY 42503 · Pulaski County
Emergency services Birthing friendly

Russell County Hospital

Critical Access Hospitals · Russell Springs, KY
OwnershipGovernment - Local
CMS Certification Number181330
Location153 Dowell RoadRussell Springs, KY 42642 · Russell County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42503 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

85.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.25
Improvement Activities40
Cost73.25

Referred Medical Equipment & Supplies CMS DME claims 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
6 suppliers53 claims53 services$20.74 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers33 claims33 services$115.64 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers20 claims20 services$29.78 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.

DR. AMR OSMAN EL-NAGGAR M.D.
Neurological Surgery
350 HOSPITAL WAY, SUITE 270
SOMERSET, KY 42503
Pulaski County (606) 678-9617
MR. RAINER ALLEN OLIVER DO
Internal Medicine
350 HOSPITAL WAY, SUITE 101
SOMERSET, KY 42503
Pulaski County (606) 451-5093
DAVID M REILLY M.D.
Family Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2601
JOSEPH G WEIGEL M.D.
Internal Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2629
MISS SUSAN MICHELE PELL ATC, PA-C
Physician Assistant
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2628
LAKE CUMBERLAND REGIONAL HOSPITAL, LLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
350 HOSPITAL WAY, SUITE 220
SOMERSET, KY 42503
Pulaski County (606) 451-0300
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Internal Medicine (Pulmonary Disease)
350 HOSPITAL WAY, SUITE 250
SOMERSET, KY 42503
Pulaski County (606) 678-0171
RICHARD F ATKINSON
Student in an Organized Health Care Education/Training Program
350 HOSPITAL WAY
SOMERSET, KY 42503
Pulaski County (630) 291-6874

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 Andrew Blakley's NPI number?

The NPI number for Andrew Blakley is 1255790051. It was assigned to this individual provider in the NPPES registry on February 22, 2016.

Where is Andrew Blakley located?

Andrew Blakley practices at 350 Hospital Way Suite 101, Somerset, KY 42503. The listed phone number is (606) 451-5093.

What is Andrew Blakley's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Andrew Blakley enrolled in Medicare?

Yes. Andrew Blakley 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 Andrew Blakley accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Andrew Blakley 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 Andrew Blakley affiliated with any hospitals?

According to CMS data, Andrew Blakley is affiliated with Lake Cumberland Regional Hospital and Russell County Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Blakley was last updated on June 26, 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.