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

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: August 09, 2026.

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

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
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

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

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.

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

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
Quality100
Improvement Activities40
Cost60.67

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.

What insurance does Audrey Blacklock accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 5 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 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.