DR. LEE ESTES BLANTON JR. MD
NPI 1417262957
Orthopaedic Surgery in Riverside, CA

NPI Status: Active since August 09, 2010

Contact Information

6405 DAY ST
RIVERSIDE, CA
ZIP 92507
Phone: (951) 697-5600
Fax: (951) 697-5475

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 17
Orthopaedic Surgery
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About LEE BLANTON

This page provides the complete NPI Profile along with additional information for Lee Blanton, a provider established in Riverside, California with a medical specialization in Orthopaedic Surgery and more than 17 years of experience. He graduated from University Of California, Geffen School Of Medicine in 2010. The healthcare provider is registered in the NPI registry with number 1417262957 assigned on August 2010. The practitioner's primary taxonomy code is 207X00000X with license number A121150 (CA). The provider is registered as an individual and his NPI record was last updated February 2026.

NPI: 1417262957
Provider Name: DR. LEE ESTES BLANTON JR. MD
Gender: Male
Entity Type: Individual
Location Address: 6405 DAY ST RIVERSIDE, CA 92507
Location Phone: (951) 697-5600
Location Fax: (951) 697-5475
Mailing Address: 6405 DAY ST RIVERSIDE, CA 92507
Mailing Phone: (951) 697-5600
Mailing Fax: (951) 697-5475
Medical School Name: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduation Year: 2010
Is Sole Proprietor?: No
Enumeration Date: 08-09-2010
Last Update Date: 02-03-2026
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Orthopaedic Surgery
Taxonomy Code: 207X00000X
Type: Allopathic & Osteopathic Physicians
License No.: A121150
License State: CA
Taxonomy Description: 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.

Medicare Participation & PECOS Enrollment Status

Lee Blanton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Lee Blanton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 1355646373
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20180116001580
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

DME-Orthotic Devices (DF000N)
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf (HCPCS:L3670)
1 DME suppliers used 12 Medicare Claims 12 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
Knee replacement
Lower limb (leg) arthroscopy (minimally invasive joint repair)
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Upper limb (arm) arthroscopy (minimally invasive joint repair)

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.97 for a new patient copayment and $18.52 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 92507 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $91.88
Minimum New Patient Price $59.6
Maximum New Patient Price $179.42

Average New Patient Copayment $22.97
Minimum New Patient Copayment $14.9
Maximum New Patient Copayment $44.85

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $74.08
Minimum Established Patient Price $19.37
Maximum Established Patient Price $146.42

Average Established Patient Copayment $18.52
Minimum Established Patient Copayment $4.84
Maximum Established Patient Copayment $36.6

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Care coordination agreements that promote improvements in patient tracking across settings	Yes	N/A
Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care.
Care transition documentation practice improvements	Yes	N/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
Care transition standard operational improvements	Yes	N/A
Establish standard operations to manage transitions of care that could include one or more of the following: Establish formalized lines of communication with local settings in which empaneled patients receive care to ensure documented flow of information and seamless transitions in care; and/or Partner with community or hospital-based transitional care services.
Clinical Information Reconciliation	13%	847
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation. The MIPS eligible clinician must implement clinical information reconciliation for the following three clinical information sets: (1) Medication. Review of the patient's medication, including the name, dosage, frequency, and route of each medication. (2) Medication allergy. Review of the patient's known medication allergies. (3) Current Problem list. Review of the patient's current and active diagnoses.
Engagement of community for health status improvement	Yes	N/A
Take steps to improve health status of communities, such as collaborating with key partners and stakeholders to implement evidenced-based practices to improve a specific chronic condition. Refer to the local Quality Improvement Organization (QIO) for additional steps to take for improving health status of communities as there are many steps to select from for satisfying this activity. QIOs work under the direction of CMS to assist MIPS eligible clinicians and groups with quality improvement, and review quality concerns for the protection of beneficiaries and the Medicare Trust Fund.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
Patient-Specific Education	99%	786
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	93%	786
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology.
Public Health Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_4_MULTI.
Request/Accept Summary of Care	95%	684
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an electronic summary of care document.
Secure Messaging	41%	786
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 certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative).
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Send a Summary of Care	83%	108
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417262957, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 2 → 4 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 4 + 6 + 4 + 9 + 1 + 0 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1417262957.