ANDRES CARLOS GOTTFRIED BLACKMORE M.D.
NPI 1629310735
Internal Medicine - Gastroenterology in San Diego, CA

Q: What is Andres Gottfried Blackmore's NPI number?

The NPI number for Andres Gottfried Blackmore is 1629310735. It was assigned to this individual provider in the NPPES registry on March 27, 2013.

Q: What is Andres Gottfried Blackmore's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Active since March 27, 2013PECOS EnrolledAccepts Medicare Assignment

76.5/100

CMS Quality Rating

200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

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

Record update history: Mar 24, 2026, Nov 21, 2025, Aug 1, 2019 (3 updates tracked since 2019).

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About Andres Carlos Gottfried Blackmore M.d. NPPES

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

ANDRES CARLOS GOTTFRIED BLACKMORE M.D. (NPI 1629310735) is an individual gastroenterology provider in San Diego, California, licensed in California (A136219) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, maintains 6 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1629310735

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameANDRES CARLOS GOTTFRIED BLACKMORECredential: M.D.

Location Address200 W ARBOR DRSan Diego, CA 92103-9000

Mailing AddressFile 57326Los Angeles, CA 90074-7326 · (800) 926-8273

Phone(800) 926-8273

Fax(888) 539-8781

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateMarch 27, 2013

Last NPPES UpdateMarch 24, 20263 updates tracked since enumeration

NPPES CertifiedMarch 24, 2026

✔ NPI 1629310735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in CA · A136219

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

200 W ARBOR DR, San Diego, CA 92103

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Secondary Practice Locations 6

Location 19300 Campus Point DrLa Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 2505 East 70th Street, Weill Cornell Internal Medicine AssociatesNew York, NY 10021 · Phone (212) 746-9663 · Fax (212) 746-3609

Location 39350 Campus Point DrLa Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 4300 Pasteur DrStanford, CA 94305-2200 · Phone (650) 723-4000

Location 56655 Alvarado RdSan Diego, CA 92120-5208 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 64250 1st AveSan Diego, CA 92103 · Phone (800) 926-8273 · Fax (888) 539-8781

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

Andres Carlos Gottfried Blackmore 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 ID3779816301

PECOS Enrollment IDI20190612003848

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 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

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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.

76.5/100

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

Scored as part of a group practice

Quality

74.31

Promoting Interoperability

100

Improvement Activities

Cost

43.95

Referred Medical Equipment & Supplies CMS DME claims

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

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

3 suppliers12 claims360 services$5.54 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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