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DALE W BLAISE MD
NPI 1770557472
Family Medicine in Murphysboro, IL

Active since February 17, 2006PECOS Enrolled
19 E SHAWNEE DR STE 2, MURPHYSBORO, IL 62966(618) 684-2172(618) 687-4480 Get Directions Write a Review

NPPES record last updated: August 24, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 24, 2022, Oct 20, 2020, Sep 17, 2020 (3 updates tracked since 2020).

About Dale W Blaise Md NPPES

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

DALE W BLAISE MD (NPI 1770557472) is an individual family medicine provider in Murphysboro, Illinois, licensed in Illinois (036065426) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770557472
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDALE W BLAISECredential: MD
Location Address19 E SHAWNEE DR STE 2Murphysboro, IL 62966-7072
Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200
Phone(618) 684-2172
Fax(618) 687-4480
Sole ProprietorNo
Enumeration DateFebruary 17, 2006
Last NPPES UpdateAugust 24, 20223 updates tracked since enumeration
NPPES CertifiedAugust 24, 2022
✔ NPI 1770557472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036065426
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
19 E SHAWNEE DR STE 2, Murphysboro, IL 62966
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Other Identifiers 4

Medicaid036065426IL
Other7210895IL · Aetna
Other3932056IL · Bcbs
Other8630880IL · Multi Plan

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dale W Blaise Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 62966 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Referred Medical Equipment & Supplies CMS DME claims 19

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers80 claims184 services$5.76 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers36 claims49 services$1.05 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
6 suppliers14 claims14 services$39.26 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers27 claims27 services$92.89 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
7 suppliers27 claims71 services$33.89 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
7 suppliers19 claims19 services$20.09 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 3

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

EMILY D HANSON DO
Family Medicine
19 E SHAWNEE DR STE 2
MURPHYSBORO, IL 62966
Jackson County (618) 684-2172
AMANDA S SAILLIEZ PAC
Physician Assistant
19 E SHAWNEE DR STE 2
MURPHYSBORO, IL 62966
Jackson County (618) 684-2172
ANGELA LEA O'DELL NP
Nurse Practitioner
19 E SHAWNEE DR STE 2
MURPHYSBORO, IL 62966
Jackson County (618) 684-2172

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 Dale Blaise's NPI number?

The NPI number for Dale Blaise is 1770557472. It was assigned to this individual provider in the NPPES registry on February 17, 2006.

Where is Dale Blaise located?

Dale Blaise practices at 19 E Shawnee Dr Ste 2, Murphysboro, IL 62966. The listed phone number is (618) 684-2172.

What is Dale Blaise's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dale Blaise enrolled in Medicare?

Yes. Dale Blaise is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dale Blaise was last updated on August 24, 2022. 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.