CARLOS M BLANCHARD MSN, RN, AGPCNP
NPI 1689109415
Nurse Practitioner - Primary Care in Marion, IN

Active since April 30, 2017PECOS EnrolledAccepts Medicare Assignment
83.71/100
CMS Quality Rating
441 N WABASH AVE, MARION, IN 46952(765) 660-6800 Get Directions Write a Review

NPPES record last updated: April 30, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carlos M Blanchard Msn, Rn, Agpcnp NPPES

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

CARLOS M BLANCHARD MSN, RN, AGPCNP (NPI 1689109415) is an individual primary care provider in Marion, Indiana, licensed in Indiana (28183638A) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Marion General Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1689109415
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameCARLOS M BLANCHARDCredential: MSN, RN, AGPCNP
Location Address441 N WABASH AVEMarion, IN 46952-2612
Mailing Address441 N Wabash AveMarion, IN 46952-2612 · (765) 660-6800
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateApril 30, 2017
NPI 1689109415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in IN · 28183638A
441 N WABASH AVE, Marion, IN 46952

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

Carlos M Blanchard Msn, Rn, Agpcnp 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 ID6002174109
PECOS Enrollment IDI20171219001582
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 5

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.
288 services124 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.
136 services127 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.
32 services19 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.
27 services26 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.
23 services23 patients

Hospital Affiliations CMS Care Compare

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

Marion General Hospital

Acute Care Hospitals · Marion, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150011
Location441 N Wabash AveMarion, IN 46952 · Grant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46952 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

83.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.94
Promoting Interoperability95
Improvement Activities40

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
2 suppliers38 claims38 services$20.24 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier11 claims11 services$778.94 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
2 suppliers34 claims34 services$111.17 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.

Dietitian, Registered
441 N WABASH AVE
MARION, IN 46952
Anesthesiology
441 N WABASH AVE
MARION, IN 46952
Occupational Therapist
441 N WABASH AVE
MARION, IN 46952
Pharmacist
441 N WABASH AVE
MARION, IN 46952
Internal Medicine
441 N WABASH AVE
MARION, IN 46952
Pharmacy (Community/Retail Pharmacy)
441 N WABASH AVE
MARION, IN 46952
Pathology (Anatomic Pathology & Clinical Pathology)
441 N WABASH AVE
MARION, IN 46952
Student in an Organized Health Care Education/Training Program
441 N WABASH AVE
MARION, IN 46952

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 Carlos Blanchard's NPI number?

The NPI number for Carlos Blanchard is 1689109415. It was assigned to this individual provider in the NPPES registry on April 30, 2017.

Where is Carlos Blanchard located?

Carlos Blanchard practices at 441 N Wabash Ave, Marion, IN 46952. The listed phone number is (765) 660-6800.

What is Carlos Blanchard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Carlos Blanchard enrolled in Medicare?

Yes. Carlos Blanchard 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 Carlos Blanchard accept?

Health plans from CareSource list Carlos Blanchard 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 Carlos Blanchard affiliated with any hospitals?

According to CMS data, Carlos Blanchard is affiliated with Marion General Hospital.

When was this NPI record last updated?

The NPPES record for Carlos Blanchard was last updated on April 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.