DR. AUDREY DEANNE BLACKLOCK MD, PHD
NPI 1912199159
Ophthalmology in N Kansas City, MO

Q: What is Audrey Blacklock's NPI number?

The NPI number for Audrey Blacklock is 1912199159. It was assigned to this individual provider in the NPPES registry on August 13, 2007.

Q: What is Audrey Blacklock's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Audrey Blacklock was last updated on October 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 August 13, 2007PECOS EnrolledAccepts Medicare Assignment

88.2/100

CMS Quality Rating

2790 CLAY EDWARDS DR STE 1240, N KANSAS CITY, MO 64116(816) 842-2015(816) 221-3713 Get Directions Write a Review

NPPES record last updated: October 6, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 6, 2022, Aug 15, 2022 (2 updates tracked since 2022).

On this page

About Dr. Audrey Deanne Blacklock Md, Phd NPPES

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

DR. AUDREY DEANNE BLACKLOCK MD, PHD (NPI 1912199159) is an individual ophthalmology provider in N Kansas City, Missouri, licensed in Missouri (2012008166) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with North Kansas City Hospital, and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (2006).

NPPES Registry Identity

NPI1912199159

Entity TypeIndividualFemale

Primary Taxonomy207W00000X

Provider Legal NameDR. AUDREY DEANNE BLACKLOCKCredential: MD, PHD

Location Address2790 CLAY EDWARDS DR STE 1240N Kansas City, MO 64116-3253

Mailing Address2790 Clay Edwards Dr Ste 1240N Kansas City, MO 64116-3253 · (816) 842-2015 · Fax (816) 221-3713

Phone(816) 842-2015

Fax(816) 221-3713

Sole ProprietorNo

Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 2006

Enumeration DateAugust 13, 2007

Last NPPES UpdateOctober 6, 20222 updates tracked since enumeration

NPPES CertifiedOctober 6, 2022

✔ NPI 1912199159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Licenses✔ Licensed in MO · 2012008166✔ Licensed in KS · 04-34305

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

2790 CLAY EDWARDS DR STE 1240, N Kansas City, MO 64116

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware 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

Dr. Audrey Deanne Blacklock Md, Phd 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 ID5395869481

PECOS Enrollment IDI20120607000022

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 Reassignment

Medicare enrollment records show Audrey Blacklock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Somers Eye Center Inc

Same address

Ophthalmology

2790 CLAY EDWARDS DR, SUITE 1240
North Kansas City, MO 64116

Reassigned Medicare billing, Missouri enrollment
2 clinicians in this Medicare group

NPI 1316045867 (816) 842-2015

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 14

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.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

522 services496 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

241 services191 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

157 services147 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

122 services76 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

118 services102 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

116 services109 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

98 services94 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

96 services55 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.

96 services63 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

43 services43 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

36 services26 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

36 services36 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

34 services34 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

24 services24 patients

Hospital Affiliations CMS Care Compare

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

North Kansas City Hospital

Acute Care Hospitals · North Kansas City, MO

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number260096

Location2800 Clay Edwards DriveNorth Kansas City, MO 64116 · Clay County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64116 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

$127.61 typical visit price

range $55.29 – $168.52

Typical copayment $31.90 (range $13.82 – $42.13)

Most-billed visit code 99204

Established Patient

$69.10 typical visit price

range $17.60 – $137.20

Typical copayment $17.27 (range $4.40 – $34.30)

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.

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.

88.2/100

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

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

60.67

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 Audrey Blacklock's NPI number?

The NPI number for Audrey Blacklock is 1912199159. It was assigned to this individual provider in the NPPES registry on August 13, 2007.

Where is Audrey Blacklock located?

Audrey Blacklock practices at 2790 Clay Edwards Dr Ste 1240, N Kansas City, MO 64116. The listed phone number is (816) 842-2015.

What is Audrey Blacklock's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Audrey Blacklock enrolled in Medicare?

Yes. Audrey Blacklock 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 organization bills Medicare for Audrey Blacklock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Audrey Blacklock reassigns Medicare benefits to Somers Eye Center Inc (North Kansas City, MO). The 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 Audrey Blacklock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Audrey Blacklock accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Anthem Blue Cross and Blue Shield and 11 other insurers list Audrey Blacklock 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 Audrey Blacklock affiliated with any hospitals?

According to CMS data, Audrey Blacklock is affiliated with North Kansas City Hospital.

When was this NPI record last updated?

The NPPES record for Audrey Blacklock was last updated on October 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.