BLAIR MACPHAIL MD
NPI 1760440127
Internal Medicine - Cardiovascular Disease in Goshen, IN

Q: What is Blair Macphail's NPI number?

The NPI number for Blair Macphail is 1760440127. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Q: What is Blair Macphail's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Blair Macphail was last updated on May 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 03, 2006PECOS EnrolledAccepts Medicare Assignment

1855 S MAIN ST, STE A, GOSHEN, IN 46526(574) 533-7476 Get Directions Write a Review

NPPES record last updated: May 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 3, 2023, Jan 15, 2021, Jan 17, 2017 and 1 more (4 updates tracked since 2016).

On this page

About Blair Macphail Md NPPES

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

BLAIR MACPHAIL MD (NPI 1760440127) is an individual cardiovascular disease provider in Goshen, Indiana, licensed in Indiana (01039182A) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Elkhart General Hospital, and is a graduate of Indiana University School Of Medicine (1985).

NPPES Registry Identity

NPI1760440127

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameBLAIR MACPHAILCredential: MD

Location Address1855 S MAIN ST, STE AGoshen, IN 46526-4852

Mailing Address1855 S Main St, Ste AGoshen, IN 46526-4852

Phone(574) 533-7476

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 1985

Enumeration DateMay 3, 2006

Last NPPES UpdateMay 3, 20234 updates tracked since enumeration

NPPES CertifiedMay 3, 2023

✔ NPI 1760440127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in IN · 01039182A

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1855 S MAIN ST, Goshen, IN 46526

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Other Identifiers 2

Medicaid100101820IN

OtherP01678724IN · Rr Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blair Macphail 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 ID2567421787

PECOS Enrollment IDI20041005000095

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.

Medicare Billing Reassignments

Medicare enrollment records show Blair Macphail reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Goshen Hospital Association Inc

0.1 mi

General Acute Care Hospital

200 HIGH PARK AVE
Goshen, IN 46526

Reassigned Medicare billing, Indiana enrollment

NPI 1740268846 (574) 533-2141

Goshen Health System Inc

0.1 mi

Family Medicine

1701 S MAIN ST
Goshen, IN 46526

Reassigned Medicare billing, Indiana enrollment
149 clinicians in this Medicare group

NPI 1194772293 (574) 364-2592

Community Physicians Of Indiana Inc

116 mi

Family Medicine

7240 SHADELAND STATION, SUITE 300
Indianapolis, IN 46256

Reassigned Medicare billing, Indiana enrollment
2,087 clinicians in this Medicare group

NPI 1619105244 (317) 355-5555

Indiana University Health Care Associates, Inc.

124 mi

Dietitian, Registered

1800 N CAPITOL AVE, B445
Indianapolis, IN 46202

Reassigned Medicare billing, Indiana enrollment
1,781 clinicians in this Medicare group

NPI 1679949002 (317) 944-3500

Indiana University Health, Inc

124 mi

Cardiovascular Disease

1701 N SENATE BLVD
Indianapolis, IN 46202

Reassigned Medicare billing, Indiana enrollment
148 clinicians in this Medicare group

NPI 1376586719 (317) 962-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 30

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.

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

313 services102 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.

305 services132 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.

278 services232 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

241 services237 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

218 services162 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

189 services38 patients

3d radiographic procedure 76376

A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.

179 services173 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

155 services119 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.

132 services121 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.

117 services47 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

108 services89 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

79 services77 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

51 services51 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

46 services36 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

45 services45 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

45 services45 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.

37 services34 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

28 services26 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

26 services25 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

24 services22 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

23 services23 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

20 services20 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.

18 services18 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.

18 services18 patients

Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

17 services17 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

17 services17 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

16 services16 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

15 services15 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

15 services14 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Elkhart General Hospital

Acute Care Hospitals · Elkhart, IN

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number150018

Location600 E BlvdElkhart, IN 46514 · Elkhart County

Emergency services Birthing friendly

Goshen Hospital

Acute Care Hospitals · Goshen, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150026

Location200 High Park AveGoshen, IN 46526 · Elkhart County

Emergency services Birthing friendly

Parkview Noble Hospital

Acute Care Hospitals · Kendallville, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150146

Location401 Sawyer RdKendallville, IN 46755 · Noble County

Emergency services Birthing friendly

Community Hospital Of Bremen Inc

Critical Access Hospitals · Bremen, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151300

Location1020 High RdBremen, IN 46506 · Marshall County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46526 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

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.

Other Providers at the Same Location NPPES 3

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

NICKIE RALSTON MSN FNP

Nurse Practitioner (Family)

1855 S MAIN ST, STE A
GOSHEN, IN 46526

Elkhart County (574) 533-7476

DR. JUSTIN JEREMIAH LIGHTBURN M.D.

Radiology (Vascular & Interventional Radiology)

1855 S MAIN ST
GOSHEN, IN 46526

Elkhart County (574) 533-7476

ABRAR RAZA SAYEED MD

Internal Medicine (Cardiovascular Disease)

1855 S MAIN ST, STE. A
GOSHEN, IN 46526

Elkhart County (574) 533-7476

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 Blair Macphail's NPI number?

The NPI number for Blair Macphail is 1760440127. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Where is Blair Macphail located?

Blair Macphail practices at 1855 S Main St Ste A, Goshen, IN 46526. The listed phone number is (574) 533-7476.

What is Blair Macphail's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Blair Macphail enrolled in Medicare?

Yes. Blair Macphail 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.

Which organizations bill Medicare for Blair Macphail's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blair Macphail reassigns Medicare benefits to 5 organizations: Goshen Hospital Association Inc (Goshen, IN), Goshen Health System Inc (Goshen, IN), Community Physicians Of Indiana Inc (Indianapolis, IN), Indiana University Health Care Associates, Inc. (Indianapolis, IN) and Indiana University Health, Inc (Indianapolis, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blair Macphail's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Blair Macphail accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Blair Macphail 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 Blair Macphail affiliated with any hospitals?

According to CMS data, Blair Macphail is affiliated with Elkhart General Hospital, Goshen Hospital, Parkview Noble Hospital and Community Hospital Of Bremen Inc.

When was this NPI record last updated?

The NPPES record for Blair Macphail was last updated on May 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.